Correlation between Homocysteine and Different Types of Coronary Heart Disease

doi:10.12114/j.issn.1007-9572.2018.00.294

Abstract

Abstract: Background　The latest study found that homocysteine （Hcy） is a newly discovered risk factor of atherosclerosis and is closely related to the occurrence of cardiovascular disease．Objective　To investigate the correlation between serum Hcy and different types of coronary heart disease （CHD）．Methods　A total of 1 303 patients with CHD admitted to General Hospital of Ningxia Medical University were retrospectively analyzed from 2015 to 2017，which included 311 cases of ST-elevation myocardial infarction （STEMI），254 cases of non ST-elevation myocardial infarction （NSTEMI），503 cases of unstable angina pectoris （UAP），235 cases of stable angina pectoris （SAP） and 242 cases of control group.General information and laboratory indexes of each group were compared，and Pearson linear correlation analysis was used to analyze the correlation between Hcy level and other laboratory indexes.Results　There were significant differences in sex，age，smoking history，hypertension and diabetes detection rate，Hcy，triglyceride （TG），total cholesterol （TC），high-density lipoprotein cholesterol （HDL-C），low-density lipoprotein cholesterol （LDL-C），lipoprotein（a）〔Lp（a）〕，glycosylated hemoglobin （HbA1c），C-reactive protein （CRP）（P<0.05）；Pearson linear correlation analysis showed that Hcy in STEMI group was positively correlated with HbA1c （P<0.05），Hcy in NSTEMI group positively correlated with TG （P<0.05），Hcy in UAP group negatively correlated with HDL-C （P<0.05） and positively correlated with Lp（a）（P<0.05），and Hcy in SAP group positively correlated with TC （P<0.05）．Conclusion　Hcy is closely related to the severity of CHD and has important clinical diagnostic value.

Key words: Coronary disease, Homocysteine, C-reactive protein

摘要： 背景　最新研究发现同型半胱氨酸（Hcy）是引起动脉粥样硬化新发现的危险因素，与心血管疾病的发生密切相关。目的　探讨不同类型冠心病患者血清Hcy水平变化及其与其他实验室检查指标的相关性。方法　选择2015—2017年宁夏医科大学总医院心内科住院确诊为冠心病的患者1 303例为研究对象，根据冠心病类型分为ST段抬高型心肌梗死（STEMI）组311例，非ST段抬高型心肌梗死（NSTEMI）组254例，不稳定型心绞痛（UAP）组503例，稳定型心绞痛（SAP）组235例，另选择同期非冠心病者242例为对照组，比较各组一般资料及实验室检查指标，采用Pearson直线相关分析各组Hcy水平与其他实验室检查指标的相关性。结果　各组性别、年龄、吸烟史、高血压及糖尿病检出率、Hcy、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、脂蛋白（a）〔Lp（a）〕、糖化血红蛋白（HbA1c）、C反应蛋白（CRP）水平比较，差异均有统计学意义（P<0.05）。相关性分析显示STEMI组Hcy与HbA1c呈正相关（P<0.05）；NSTEMI组Hcy与TG呈正相关（P<0.05）；UAP组Hcy与HDL-C呈负相关（P<0.05），与Lp（a）呈正相关（P<0.05）；SAP组Hcy与TC呈正相关（P<0.05）。结论　Hcy与冠心病疾病严重程度存在密切联系，具有重要的临床诊断价值。

关键词: 冠心病, 同型半胱氨酸, C反应蛋白质

LIU Xianghong,SHI Zhiyun,LIU Huiling, et al. Correlation between Homocysteine and Different Types of Coronary Heart Disease[J]. Chinese General Practice, 2019, 22(8): 920-924. DOI: 10.12114/j.issn.1007-9572.2018.00.294.
刘祥红,师志云,刘会玲等. 不同类型冠心病患者血清同型半胱氨酸水平变化研究[J]. 中国全科医学, 2019, 22(8): 920-924. DOI: 10.12114/j.issn.1007-9572.2018.00.294.

References

［1］宋艳东，陶英，王苏，等．冠心病患者同型半胱氨酸、血尿酸水平与冠脉病变的相关性［J］．中华急诊医学杂志，2017，26（4）：430-433．DOI：10.3760/cam.j.issn.1671-0282.2017.04.015.
SONG Y D，TAO Y，WANG S，et al．Correlation between serum homocysteine level，serum uric acid level and coronary lesion severity in coronary artery disease patients［J］．Chinese Journal of Emergency Medicine，2017，26（4）：430-433．DOI：10.3760/cam.j.issn.1671-0282.2017.04.015.
［2］张建，华琦.冠心病基础与临床［M］．北京：人民卫生出版社，2008：28-151.
ZHANG J，HUA Q.Foundation and clinical of coronary heart disease［M］.Beijing：People's Medical Publishing House，2008：28-151.
［3］章志玲，张明，葛郁芝.MTHFR基因多态性与急性心肌梗死的相关性分析［J］．中国心血管病研究，2017，9（15）：801-803．DOI：10.3969/j.issn.1672-5301.2017.09.008.
ZHANG Z L，ZHANG M，GE Y Z.The correlation between gene polymorphism of methylenetetrahydrofolate reductase（MTHFR） and patients with acute myocardial infarction［J］．Chinese Journal of Cardiovascular Research，2017，9（15）：801-803．DOI：10.3969/j.issn.1672-5301.2017.09.008.
［4］LI Y Y.Methlenetetrahydrofolate reductase C677T gene polymorphism and coronary artery disease in a Chinese Han population：a meta-analysis［J］．Metabolism，2012，61（6）：846-852．
［5］许海燕，陈在嘉，汤健，等．冠心病患者同型半胱氨酸代谢相关酶基因多态性的研究［J］．中华医学杂志，1999，85（6）：414-416.
XU H Y，CHEN Z J，TANG J，et al．Genetic polymorphisms of homocysteine metabolism related enzymes in patients with coronary heart disease［J］．National Medical Journal of China，1999，85（6）：414-416.
［6］KUMAKURA H，FUJITA K，KANAI H，et al．High-sensitivity C-reactive protein，lipoprotein（a） and homocysteine are risk factors for coronary artery disease in Japanese patients with peripheral arterial disease［J］．J Athcroscler Thromb，2015，22（4）：344-354．DOI：10.5551/jat.25478.
［7］ABRAHAM W T，STEVENSON L W，BOURGE R C，et al．Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy：complete follow-up results from the CHAMPION randomised trial［J］．Lancet，2016，387（10017）：453-461．DOI：10.1016/S0140-6736（15）00723-0.
［8］RUBIN L J，GALIE N，GRIMMINGER F，et al．Riociguat for the treatment of pulmonary arterial hypertension：a long-term extension study （PATENT-2）［J］．Eur Respir J，2015，45（5）：1303-1313．DOI：10.1183/09031936.00090614.
［9］MADAMANCHI C，ALHOSAINI H，SUMIDA A，et al．Obesity and natriuretic peptides，BNP and NT-proBNP：mechanisms and diagnostic implications for heart failure［J］．Int J Cardiol，2014，176（3）：611-617．DOI：10.1016/j.ijcard.2014.08.007.
［10］CHASAN-TABER L，SELHUB S，ROSENBERG I H，et al．A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians［J］．J Am Coll Nutr，1996，15（2）：136-143.
［11］汪蕾，蔡濛，张萍.老年患者冠心病危险程度与血浆同型半胱氨酸及尿酸水平的相关研究［J］．心肺血管病杂志，2017，36（8）：629-632，637．DOI：10.3969/j.issn.1007-5062.2017.08.006.
WANG L，CAI M，ZHANG P.Association of hyperhomocysteinemia and hyperurieemia with coronary events in elderly patients［J］．Journal of Cardiovascular and Pulmonary Diseases，2017，36（8）：629-632，637．DOI：10.3969/j.issn.1007-5062.2017.08.006.
［12］张鸿修，黄体钢.实用冠心病学［M］．天津：天津科技翻译出版公司，2005：142.
ZHANG H X，HUANG T G.Practical coronary heart disease［M］.Tianjin：Tianjin Science and Technology Translation Publishing Company，2005：142.
［13］徐宏斌.脂蛋白和同型半胱氨酸与心脑血管疾病关系的研究［J］.中国现代药物应用，2016，10（4）：13-14．DOI：10.14164/j.cnki.cn11-5581/r.2016.04.007.
XU H B.Study on the relationship between lipoprotein and homocysteine and cardiovascular and cerebrovascular diseases［J］.Chinese Journal of Modern Drug Application，2016，10（4）：13-14．DOI：10.14164/j.cnki.cn11-5581/r.2016.04.007.
［14］陶春燕.急性心肌梗死患者脂蛋白a与冠脉病变程度之间的关联分析［D］．苏州：苏州大学，2013.
TAO C Y.Association analysis between lipoprotein a and severity of coronary artery disease in patients with acute myocardial infarction［D］．Suzhou：Soochow University，2013.
［15］GONCALVES I，EDSFELDT A，KO N Y，et al．Evidence supporting a key role of Lp-PLA2-generated lysophosphatidylcholine in human atherosclerotic plaque inflammation［J］．Arterioscler Thromb Vasc Biol，2012，32（6）：1505-1512．DOI：10.1161/ATVBAHA.112.249854.
［16］KEENAN T E，RADER D J.Genetics of lipid traits and relationship to coronary artery disease［J］．Curr Cardiol Rep，2013，15（9）：396．DOI：10.1007/s11886-013-0396-9.
［17］邵俊良，孙剑，韦勇，等．冠心病患者血清同型半胱氨酸和脂蛋白a联合检测的临床意义［J］．国际检验医学杂志，2015，36（2）：255-256．DOI：10.3969/j.issn.1673-4130.2015.02.049.
SHAO J L，SUN J，WEI Y，et al．Clinical significance of combined detection of serum serotypes of homocysteine and lipoprotein a in patients with coronary heart disease［J］．International Journal of Laboratory Medicine，2015，36（2）：255-256．DOI：10.3969/j.issn.1673-4130.2015.02.049.
［18］莫惠芳，张爱伦，吴炯，等．同型半胱氨酸在糖尿病大血管病变中的意义及危险因素分析［J］．中华检验医学杂志，2017，40（7）：526-531．DOI：10.3760/cma.j.issn.1009-9158.2017.07.011.
MO H F，ZHANG A L，WU J，et al．The significance and risk factor analysis of homocysteine in diabetic patients with macroangiopathy［J］．Chinese Journal of Laboratory Medicine，2017，40（7）：526-531．DOI：10.3760/cma.j.issn.1009-9158.2017.07.011.
［19］卢山，邱爽，王旭，等．血液同型半胱氨酸和糖化血红蛋白水平在糖尿病视网膜病变中的意义［J］．中华检验医学杂志，2015，38（12）：818-821．
LU S，QIU S，WANG X，et al．Clinical significance of blood homocysteine and glycated hemoglobin in patients with diabetic retinopathy［J］．Chinese Journal of Laboratory Medicine，2015，38（12）：818-821．
［20］NIKOLAKOPOULOU S，HILLAS G，PERREA D，et al．Serum angiopoietin-2 and CRP levels during COPD exacerbations［J］．COPD，2014，11（1）：46-51．DOI：10.3109/15412555.2013.829436.
［21］程松树，胡小红.冠心病患者血清C反应蛋白、同型半胱氨酸生化指标的临床检测分析［J］．现代诊断与治疗，2015，26（17）：3857-3858.

[1]	ZHOU Qibao, LUO Xiao, CHEN Ling, CAO Junda, LI Juxiang, XU Jinsong, SU Hai. Clinical Study on the Diagnostic Value of Circadian Variability of Systolic Blood Pressure Combined with SDNN in Coronary Heart Disease [J]. Chinese General Practice, 2025, 28(30): 3760-3765.
[2]	WU Wenjun, WEI Jingjing, LI Xue, REN Hongjie, YU Rui, PENG Guangcao, ZHU Mingjun. Regularity of Prescriptions for Coronary Heart Disease with Hypertension Based on Latent Structure and Association Rules [J]. Chinese General Practice, 2025, 28(30): 3787-3795.
[3]	YANG Ji, ZHANG Yao, ZHAO Yingqiang, ZHANG Qiuyue. Evaluation of the Effectiveness of TCM Three-level Prevention and Control Model in the Management of Patients with Coronary Heart Disease and Stroke: a Single-center, Prospective Cohort Study [J]. Chinese General Practice, 2025, 28(22): 2750-2761.
[4]	ZHANG Ning, FAN Shiming, REN Ming, SHEN Youlu, MA Yanmei, DOU Xiaohong, PU Cuo, LU Xingqin, HUANG Qiang, XUE Rui, WANG Fuyan, LIN Ying, ZHANG Jihui, TIAN Huizhen, HAN Ping, HAN Yujuan, HAN Shuping, LIU Qingling, LU Tianlong, LU Yongliang, E Weijian. Study on the Relationship between Homocysteine Levels, Polymorphisms of Homocysteine Metabolizing Enzyme Genes, Blood Pressure, and Oxidative Stress Levels in Hypertensive Patients at Different Altitudes [J]. Chinese General Practice, 2025, 28(15): 1862-1870.
[5]	LI Mei, JIANG Dongsheng, ZHAO Jingjing, CAO Yajing, ZHANG Fan, TANG Lijuan, LIU Xiaoli. Correlation Analysis of Homocysteine and Stroke in People over 40 Years Old [J]. Chinese General Practice, 2025, 28(14): 1723-1729.
[6]	JIA Shuo, CHENG Gong, GUAN Lei, FENG Panpan, XU Bailing, FANG Wei, ZHANG Ji. Diagnostic Performance of SPECT in Patients with Coronary Microcirculation Disturbance after PCI [J]. Chinese General Practice, 2025, 28(09): 1122-1127.
[7]	MA Juan, MA Shengzong, YAN Ru, MA Xueping, JIA Shaobin. Predictive Effect of C-reactive Protein Albumin Ratio on Long-term Adverse Cardiovascular Events in Patients with Type 2 Diabetes Mellitus and Acute Myocardial Infarction [J]. Chinese General Practice, 2025, 28(06): 705-712.
[8]	YUE Haitao, HE Chanchan, CHENG Yuyou, ZHANG Sencheng, WU You, MA Jing. Coronary Heart Disease Risk Prediction Model Based on Machine Learning [J]. Chinese General Practice, 2025, 28(04): 499-509.
[9]	YANG Hong, LIU Cheng, LIU Sen, SHAO Qiqi, YAO Yuanhao, FU Zhenyan. Association of Residual Cholesterol with Vulnerable Plaques in Non-culprit Lesions Progressing to Major Adverse Cardiovascular Events [J]. Chinese General Practice, 2025, 28(03): 299-304.
[10]	ZHANG Ming, WANG Wenjuan, HAO Wen, CHEN Jibin, XIA Wei, SHAO Yibing, WANG Bin. Clinical Research of Obstructive Sleep Apnea and Acute Coronary Syndrome: Current Status and Future Direction [J]. Chinese General Practice, 2025, 28(03): 257-261.
[11]	SUN Xuechun, DU Zhiyong, YU Huahui, LYU Qianwen, JIAO Xiaolu, WANG Yu, QIN Yanwen. Value of Lysophospholipid Metabolites in Prognosis of Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: a Prospective Cohort Study [J]. Chinese General Practice, 2024, 27(36): 4540-4545.
[12]	LUO Qin, GOU Lianping, CHEN Yin, SU Feng. Comparison of the Diagnostic Value of Calf Circumference, Upper Arm Circumference and Ishii Score in Patients with Coronary Heart Disease Complicated with Sarcopenia [J]. Chinese General Practice, 2024, 27(35): 4403-4411.
[13]	CHEN Ruman, BAI Yafei, WANG Chunli, AN Na, XU Mingzhi, HE Jiqing, QI Yonghui, WANG Liheng, LI Hong. Combined Predictive Value of Neutrophil-to-lymphocyte Ratio and C-reactive Protein-to-albumin Ratio for All-cause Mortality Risk in Patients with Maintenance Hemodialysis: Cohort Study Followed for 5 Years [J]. Chinese General Practice, 2024, 27(35): 4397-4402.
[14]	JIA Gaopeng, QU Ze, LI Guimei, HUANGFU Weizhong, ZHAO Zihao, YAN Shuang, CHEN Qiuyu, ZHANG Yue. Effectiveness and Safety of Drug-coated Balloons in Treating De Novo Lesions in Large Coronary Vessels of Elderly Patients: a Cohort Study [J]. Chinese General Practice, 2024, 27(33): 4125-4131.
[15]	LI Yong, LI Zhanhu, JIN Bowei, LI Yuan, ZHANG Hongbo, SU Yakun, YAN Xiaoju. Correlation between Serum Complement C1q/Tumor Necrosis Factor-related Protein 5 Levels and the Severity of Coronary Artery Lesions and Myocardial Fibrosis Markers in Patients with Acute Coronary Syndrome [J]. Chinese General Practice, 2024, 27(27): 3365-3371.