关键词: 同型半胱氨酸, 高血压前期, 高血压, 预测

Abstract: June 2013 and June 2014，we recruited 421 individuals with prehypertension who received health examination in Jiading District Nanxiang Town Community Health Center，Shanghai.Baseline data including laboratory testing results were collected.Enzymatic cycling assay was used to determine the serum Hcy level.Based on the level of serum Hcy，they were classified into Q1 group （quartile 1：Hcy<11.2 μmol/L，n=105），Q2 group （quartile 2：Hcy 11.2-13.7 μmol/L，n=105），Q3 group （quartile 3：Hcy 13.8-16.4 μmol/L，n=105） and Q4 group （quartile 4：Hcy>16.4 μmol/L，n=106）.During the follow-up period，all the participants underwent physical examination once a year，in particular，the incidence of hypertension was evaluated，and 128 were found with hypertension and 293 without were assigned to hypertension group，non-hypertension group，respectively.Comparisons were made between hypertension and non-hypertension groups in terms of serum Hcy level and between Hcy groups in respect to the incidence of hypertension.Moreover，the associated factors for the progression of prehypertension to hypertension were explored.Results　The mean follow-up duration was （2.6±0.9） years，during which the incidence of hypertension was 30.4%.Compared with the non-hypertension group，hypertension group had higher mean age，mean BMI，mean systolic blood pressure（SBP），mean diastolic blood pressure（DBP），mean fasting blood glucose（FBG） and mean Hcy levels，and a higher proportion of men，but a lower proportion of patients who had regular physical activity at baseline （P<0.05）.The incidence of hypertension in Q1，Q2，Q3 and Q4 groups was 16.2% （17/105），23.8% （25/105），33.3% （35/105） and 48.1% （51/106），respectively，indicating that it increased along with the elevation of Hcy levels （χ2trend =28.320，P<0.001）.Multivariate Logistic analysis revealed that age，regular physical activity，BMI，SBP and Hcy level were the associated factors of the progression to hypertension for prehypertension patients （P<0.05）.Conclusion　Elevated serum Hcy level is an independent risk factor for progression of prehypertension to hypertension，suggesting that measurement of Hcy may be helpful for the risk stratification and early management of these patients.

Key words: Homocysteine, Prehypertension, Hypertension, Forecasting