论文部分内容阅读
评估4766名老年男女同型半胱氨酸及其相关因子作为髋骨骨折的风险因子。高同型半胱氨酸水平和低叶酸水平可预测骨折,而维生素B12及其基因型与骨折风险没有关系。高同型半胱氨酸水平可能是髋骨骨折的一个可变风险因子。血浆总同型半胱氨酸(tHcy)升高和叶酸及维生素B12缺乏与骨质疏松及骨折风险有关。我们研究血浆tHcy水平、叶酸、维生素B12和亚甲基四氢叶酸还原酶(MTHFR)677C→T和1298C→T多态性是否可预测骨折。材料和方法这是一项2639名女性和2127名男性的人群前瞻性研究,选择了1992年-1993年年龄在65岁-67岁的男女性。骨折信息来自从进入研究期至2005年11月30日期间该地区所有住院治疗公开诊断的计算机记录。按血浆tHcy水平、叶酸、和维生素B12及其不同基因型等变量,应用Cox比例风险回归估计骨折风险。结果在12.6年的随访期中,记录了184名女性(7.0%)和90名男性(4.2%)髋骨骨折患者。tHcy高水平(≥15μmol)相对于低水平(<9.0μmol=,研究对象骨折调整风险比例(95%CI)女性是2.42(1.43～4.09)、男性是1.37(0.63～2.98)。剂量-反应分析表明,男女性血浆tHcy与骨折风险间存在正相关,而仅女性血浆叶酸与骨折风险存在负相关。调整混杂因素后,血浆维生素B12水平或MTHFR基因型与骨折风险没有显著性关联。经调整血浆维生素B12和叶酸水平,tHcy与髋骨骨折间的关联仅轻微减弱。结论老年男女性tHcy可能是髋骨骨折的预测因子。叶酸仅是女性的预测因子,而维生素B12和MTHFR基因型不能预测髋骨骨折。我们的资料确证了同型半胱氨酸在骨质疏松性骨折发病机制中可能起作用的假设。
4766 elderly men and women with homocysteine and its related factors were evaluated as risk factors for hip fracture. High homocysteine levels and low folate levels predict fractures, whereas vitamin B12 and its genotype are not associated with the risk of fracture. Homocysteine levels may be a variable risk factor for hip fracture. Elevated plasma total homocysteine (tHcy) and folic acid and vitamin B12 deficiency are associated with osteoporosis and the risk of fracture. We investigated whether plasma tHcy levels, folic acid, vitamin B12, and MTHFR 677C → T and 1298C → T polymorphisms predict fractures. Materials and Methods This prospective study of 2639 women and 2127 men selected men and women aged 65 to 67 from 1992 to 1993. Fracture information was obtained from a computerized record of public diagnosis of all hospitalizations in the area from the study period until November 30, 2005. According to the plasma tHcy levels, folic acid, vitamin B12 and their different genotypes, Cox proportional hazards regression was used to estimate the fracture risk. Results During the 12.6 year follow-up period, 184 women (7.0%) and 90 men (4.2%) with hip fracture were recorded. The risk of fracture-adjusted risk (95% CI) was 2.42 (1.43 to 4.09) in women and 1.37 (0.63 to 2.98) in men at a high tHcy (≥15 μmol) relative to low levels (<9.0 μmol = Showed that there was a positive correlation between plasma tHcy in men and women and risk of fracture but only female plasma folate was negatively correlated with the risk of fracture.After adjusting for confounding factors, there was no significant correlation between plasma vitamin B12 level or MTHFR genotype and fracture risk. The association between tHcy and hip fractures was only slightly weakened at vitamin B12 and folic acid levels.Conclusions tHcy may be a predictor of hip fracture in older men and women.Folicy acid is only a predictor of women whereas vitamin B12 and MTHFR genotypes do not predict hip Fractures. Our data confirm the hypothesis that homocysteine may play a role in the pathogenesis of osteoporotic fractures.