Objective To assess the effect of B vitamins supplementation on cardiovascular and cerebrovascular diseases, and also to evaluate the relationship between homocysteine and risk of cardiovascular and cerebrovascular diseases. Methods Using the words ‘homocysteine’, ‘cardiovascular disease’, ‘cerebrovascular disease’, ‘B vitamins’, and ‘randomized controlled trial’, we searched PubMed, Ovid, and Springer. We also hand searched relevant journals and conference proceedings. Randomized controlled trials published between 1998 and July 2008 which evaluated the effect of B vitamins supplementation on vascular diseases were collected. Two reviewers independently screened trials, extracted data, and evaluated the quality of included trials. The Cochrane Collaboration’s RevMan 4.2 software was used for statistical analysis. Results Sixteen trials involving 27,043 patients with vascular disease were included. Results of meta-analyses showed that no significant differences were identified between the B vitamins group and the control group for each of the four endpoints, including the risk of cardiovascular events (RR 0.98, 95%CI 0.94 to 1.03), the risk of coronary heart disease (RR 0.99, 95%CI 0.92 to 1.07), the risk of stroke (RR 0.90, 95%CI 0.80 to 1.02), and the total mortality (RR 0.98, 95%CI 0.92 to 1.05). Sensitivity analyses conducted by a random effect model or with the exclusion of low-quality trials did not change the overall results. Conclusion The trials currently available cannot confirm the causal relationship between homocysteine and risk of cardiovascular and cerebrovascular diseases. More evidence from large-scale randomized controlled trials is needed to confirm this. There is not sufficient evidence to show that B vitamins supplementation can lower the risk of cardiovascular and cerebrovascular diseases. B vitamins supplementation should not be recommended for the secondary prevention of such diseases.
Objective To evaluate the association between coronary heart disease (CHD) and plasma homocysteine level, and to provide additional information for prevention and management of CHD. Methods We searched CBM, CNKI, WanFang, and VIP databases. Case-control studies about the association between CHD and plasma homocysteine level published in China were identified. Meta-analysis was performed using RevMan 4.2 software. Results The result of meta-analysis showed the plasma homocysteine level in the CHD group was higher than that of the control group (WMD=4.88, 95%CI 4.40 to 5.35, Plt;0.000 01), and the loss of safety coefficient was 1 339. Conclusion High plasma homocysteine level is associated with increasing morbidity of CHD.
目的 研究同型半胱氨酸转硫途径、维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期（AECOPD）中的作用。 方法 2010年2月－4月间筛选AECOPD患者16例和健康志愿者（对照组）13例，测定AECOPD患者加重期、缓解期及对照组的肺功能、血清硫化氢（H2S）、丙二醛（MDA）、叶酸、维生素B12、C反应蛋白、白介素6、血浆同型半胱氨酸、胱硫醚、半胱氨酸和维生素B6的浓度。计算半胱氨酸转化率（半胱氨酸浓度/胱硫醚浓度）与胱硫醚转化率（胱硫醚浓度/同型半胱氨酸浓度）参与分析。 结果 ① 加重期血清MDA水平[（7.3 ± 5.1）nmol/L ]比缓解期[（3.0 ± 1.4）nmol/L ]和对照组[（3.0 ± 2.2）nmol/L ]均升高（P＜0.01）；血清MDA水平与第1秒用力呼气容积/用力肺活量（FEV1/FVC）、第1秒用力呼气容积占预计值百分比（FEV1%预计值）呈负相关。② 加重期血清H2S水平与血浆维生素B6水平较缓解期与对照组降低（P＜0.01）；缓解期血清H2S水平[（47.2 ±5.1） μmol/L ]高于对照组[（38.8 ± 2.1） μmol/L ]，P＜0.01；血清H2S水平、血浆维生素B6水平均与FEV1%预计值呈正相关（r=0.651、0.680，P＜0.01），均与血清MDA水平呈负相关（r=-0.334、-0.448，P＜0.05）。③ 加重期半胱氨酸转化率（3.97 ± 2.41）低于缓解期（5.92 ± 2.18）与对照组（6.14 ± 3.15）差异有统计学意义（P＜0.05）；而胱硫醚转化率则相反。④ 叶酸与维生素B12水平各组间均无差异。 结论 提高AECOPD患者维生素B6及H2S浓度可能能促使AECOPD患者向稳定状态转归，减轻氧化应激损伤。维生素B6与H2S可能成为AECOPD患者的一个新的治疗点。Objective To study the roles of homocysteine (Hcy) transsulfuration pathway, Vitamin B6 and endogenous hydrogen sulfide in treating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Sixteen AECOPD patients and 13 healthy controls (Control group) from February to April 2010 were recruited in this study. Lung function, serum hydrogen sulfide (H2S), malondialdehyde (MDA), folate, vitamin B12, C-reactive protein (CRP), interleukin-6 (IL-6), Hcy, cystathionine, cystein (Cys) and vitamin B6 were all measured for all the patients in the acute exacerbation period and alleviation period and healthy controls. The conversion rate of Cys (expressed as Cys/cystathionine) and the conversion rate of cystathionine (expressed as cystathionine/Hcy) were calculated for analysis. Results Serum MDA level for patients in the acute exacerbation period (AE period) [(7.3 ± 5.1) nmol/L] was significantly higher than that in the alleviation period [(3.0 ± 1.4) nmol/L] and in the healthy controls [(3.0 ± 2.2) nmol/L] (P ＜ 0.01). Serum MDA level was negatively correlated with percentage of FEV1 in predicted FEV1 (FEV1% pred) and FEV1/FVC. Serum H2S level and plasma vitamin B6 level for patients in the AE period were significantly lower than those in the alleviation period and in the healthy controls (P ＜ 0.01), and serum H2S level was significantly higher in the alleviation period [(47.2 ± 5.1) μmol/L] than in the controls [(38.8 ± 2.1) μmol/L] (P ＜ 0.01). Both serum H2S and plasma vitamin B6 levels were correlated positively with FEV1% pred for patients in the AE period and healthy controls (r=0.651, 0.680; P ＜ 0.01), but negatively correlated with serum MDA level (r=-0.334, -0.448; P ＜ 0.05). The conversion rate of Cys for patients in the AE period (3.97 ± 2.41) was significantly lower than that in the alleviation period (5.92 ± 2.18) and the control group (6.14 ± 3.15) (P ＜ 0.05), but the conversion rate of cystathionine was just the opposite (P ＜ 0.05). There were no significant differences in the levels of serum folate and vitamin B12 among the three groups. Conclusion Raising the Vitamin B6 and H2S level may facilitate stabilizing of conditions in patients with AECOPD and reduce oxidative stress. Therefore, it may become a new treatment method for AECOPD.
目的 建立柱前衍生化反相高效液相色谱-荧光检测法测定血浆中同型半胱氨酸（Hcy）浓度的方法。 方法 以tris-(2-carboxylethyl)-phosphine hydrochloride （TCEP）为还原剂，以7-fluorbenzo-2-oxa-1,3-diazole-4-sulfonate （SBD-F）为衍生剂，色谱柱为Xterra RP18柱，柱温35℃，流动相为甲醇︰磷酸二氢钠缓冲液（pH值3.0）=3︰97，激发波长380 nm，发射波长510 nm，外标法定量。 结果 Hcy浓度在1.95～125 ?mol/L范围内线性关系良好（r=0.999 8）。日内和日间相对标准偏差均＜7%，方法回收率为103.2%～111.9%。 结论 此方法准确、灵敏、快速，是一种适合于实验室研究和临床检测血浆中Hcy浓度的方法。
目的 探讨缺血性脑血管病患者高同型半胱氨酸(Hcy)血症与颅内外动脉狭窄的关系。 方法 2007年6月-2009年12月收治缺血性脑血管病患者90例，根据全脑血管造影检查结果分为颅内外动脉狭窄组和颅内外动脉无狭窄组；颅内外动脉狭窄组依狭窄部位分为单纯颅内动脉狭窄组、单纯颅外动脉狭窄组及颅内外动脉均有狭窄组；分析各组同型半胱氨酸的水平。 结果 颅内外动脉狭窄组血浆Hcy水平显著高于颅内外动脉无狭窄组(Plt;0.05)；单纯颅内动脉狭窄组、单纯颅外动脉狭窄组及颅内外动脉均有狭窄组血浆Hcy水平均显著高于颅内外动脉无狭窄组(Plt;0.05)。 结论 高同型半胱氨酸血症是颅内外动脉狭窄的危险因素，是单纯颅内动脉狭窄及单纯颅外动脉狭窄的共同危险因素。
摘要:目的: 探讨动脉硬化闭塞症(ASO)和静脉血栓形成(VT)患者同型半胱氨酸(Hcy)变化。 方法 :通过循环酶法对34例非动脉硬化闭塞症(ASO)和静脉血栓形成(VT)患者(对照组),30例动脉硬化闭塞症(ASO)患者和26例静脉血栓形成(VT)患者血液中Hcy进行测定。 结果 :循环酶法测定HCY的批内平均变异系数为2．23％,批间平均变异系数为1．59％。34例对照组,〖WTBX〗t =1135,〖WTBX〗P =0266gt;005;动脉硬化闭塞症(ASO)组Hcy含量明显高于对照组(〖WTBX〗P lt;O．05),静脉血栓形成(VT)组Hcy含量高于对照组(〖WTBX〗P lt;0．O5)。 结论 :高同型半胱氨酸血症可能是动脉硬化闭塞症(ASO)和静脉血栓形成(VT)及复发的致病因素。可将同型半胱氨酸作为动脉硬化闭塞症(ASO)和静脉血栓形成(VT)及复发的重要指标。Abstract: Objective: TO syudy the changes of the Homocysteine about Atherosclerosis obliterans and Venous thrombosis patients. Methods : To measure the Hcy in the blood of 34 healthy cases both non ASO and non VT(the comparison group),30 cases of ASO patients and 26 cases of VT patients respectively by enzymatic cycling assay。〖WTHZ〗Results :The average variation coefficient of Hcy within the groups was 223% and among the groups was 159% measured by enzymatic cycling assay.In the 34 cases of comparison group,t=1135,P=0266gt;005,The content of Hcy in the blood of ASO patients group were significantly higher than the comparision group (Plt;005),and the content of Hcy in the blood of VT patients group were also higher than the comparison group (Plt;005). Conclusion : Hyper Hcy may be the pathogenic diathesis to form or to recrudesce ASO and VT.So we can treat Hcy as the significant index to form or to recrudesce ASO and VT.
Objective To explore the correlation between homocysteine （Hcy） level and the risk of breast cancer，and try to find a new method to reduce the risk factors and benefit for treatment of breast cancer. Methods From January2010 to December 2012， 245 cases of breast cancer （breast cancer group）， 109 cases of benign breast tumor （benign breast tumor group）， and 78 cases of healthy women （healthy control group） in the Sichuan Provincial People’s Hospital， who were in accordance with the inclusion criteria， were analyzed retrospectively. The difference of Hcy level was compared among three groups. Meanwhile the relation between Hcy level and patients’s age， blood glucose， serum creatinine， estrogen receptor （ER）， progesterone receptor （PR）， Ki-67 （%）， tumor diameter， or axillary lymph node status was analyzed.Results ① The Hcy level was significantly different among the breast cancer group， benign breast tumor group， and healthy control group （P＜0.001）. The Hcy level of the breast cancer group was significantly higher than those of the benignbreast tumor group （P＜0.001） or healthy control group （P＜0.001）， but the Hcy level was not significantly different bet-ween the benign breast tumor group and healthy control group （P=0.082） . ② The Hcy levels of different types of the breastcancer （type of Luminal A， Luminal B， Her-2， and triple negative） were significantly higher than those of the benign breast tumor group （except for Her-2 type， P＜0.05） or healthy control group （P＜0.05）. ③Plasma Hcy level of the patients with benign and malignant breast tumor was positively correlated with age （r=0.197， P=0.004） or serum creatinine level （r=0.381， P＜0.001）， but not correlated with blood glucose （r=0.023， P=0.668）. ④Plasma Hcy level of the patients with malignant breast tumor was positively correlated with age （r=0.267， P=0.007） or serum creatinine level （r=0.341， P＜0.001）， but not correlated with blood glucose （r=-0.005， P=0.935）， tumor diameter （r=-0.049， P=0.443）， axillary lymph node status （r=-0.006， P=0.921）， or Ki-67 （%） （rs=-0.029， P=0.650）. Conclusions Plasma Hcy level of breast cancer patient is abnormally elevated， and it may have some relation with the occurrence of breast cancer.