Correlation between mild and moderate hyperhomocysteinem and coronary heart disease

CHEN Shun-hua; ZHANG Dong-hua; GUO Fang; FENG Yan; WANG Yi-xin

doi:10.3760/cma.j.issn.1673-4777.2013.06.005

Abstract：Objective To study the correlation between plasma homocysteine(Hcy) and coronary heart disease(CHD),and to discuss the mechanism of Hcy inducing CHD,so that providing data for clinic job.Methods All 356 CHD patients were investigated.Among the patients,there were 279 with acute coronary syndrome (ACS group) and 77 with stable angina pectoris (SAP group).At the same time 159 normal persons were selected as control group (NC group).Sex,age,body mass index(BMI),history of smoking,hypertension,diabetes,hypercholesterolemia,cerebrovascular disease,the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),plasma Hcy,plasma fibrinogen(Fib) and highsensitivity C-reactive protein (hs-CRP) were detected.The traditional risk factors and plasma Hcy,Fib,hs-CRP were compared between groups.The multiple risk factors of CHD were analyzed by using Logistic regression model for determining whether Hcy was an independent risk factor of CHD.Results There were no statistically differences among three groups in terms of age,history of hypertension and hypercholesterolemia,the level of TC,LDL-C (P ＞0.05).There were statistically difference in three groups on sex,history of smoking,diabetes,cerebrovascular disease and the level of HDL-C(P ＜0.05).The levels of plasma Hcy,hs-CRP,Fib in ACS group were statistically higher than those in SAP group and NC group [Hcy:(21 ± 6) μmol/L vs (16 ± 5),(14 ± 5) μmol/L; hs-CRP:(4.5 ±2.1)mg/L vs(2.8 ± 1.9),(2.1 ± 1.9)mg/L; Fib:(4.1 ±0.9)g/L vs(2.6 ±0.7),(2.7 ±0.8) g/L](P ＜ 0.05) ;The levels of plasma Hcy were statistically higer in SAP group than that in NC group (P ＜ 0.05),but the levels of hs-CRP and Fib were no difference between SAP group and NC group(P ＞ 0.05).Patients with hyperhomocysteinem(Hcy ＞ 15 μmol/L)were more in ACS group than those in NC and SAP group(P ＜ 0.05),but there was no difference between NC and SAP group(P ＞0.05).The multiple analysis of Logistic regression showed that whether the level of plasma Hcy or hyperhomocysteinem were an independent risk factor of CHD; the relative risk was 1.087 [odds ratio (OR) =1.087,95％ confidence interval(CI) 1.045-1.131,P ＜ 0.01) and 2.582 (OR =2.582,95％ CI 1.643-4.056,P ＜ 0.01).Conclusions The Hcy is an independent risk factor of CHD.The level of plasma Hcy is higher in ACS patients than that in SAP patients,which indicates that Hcy may increase the risk of CHD through inducing inflammation and thromb.