Study On Relation Between The Level Of Homocysteine And The Severity Of Carotid Artery Atherosclerosis

Homocysteinemia(Homocysteinemia Hcy)is the process of methionine that methionine cycle produced by the intermediate material,can not directly synthesize protein,2010 Chinese Hypertension Prevention Guide plasma Hcy concentration> 10?mol/L is defined as hyperhomocysteinemia(HHcy).A large number of epidemiological investigations and clinical trials have shown that mild to moderate increase in Hcy is one of the important factors of vascular ischemic disease,independent of the traditional risk factors of atherosclerosis.Objective: To study the correlation between plasma homocysteine level and carotid atherosclerosis and stenosis.Methods: A total of 495 patients underwent cervical artery color Doppler ultrasonography between December 2015 and November 2016 were enrolled in the Second Hospital of Jilin University.Including 205 females and 290 males,with an average age of 64.92 ± 9.16 years.Which except oral B vitamins,folic acid,contraceptives and other effects of homocysteine metabolic drugs in patients,except for cardiogenic and other causes of carotid artery thrombosis patients,excluding heart and lung liver and kidney failure,thyroid dysfunction patients.All patients were admitted to the hospital after the collection of fasting elbow venous blood,blood,liver function,blood lipids,renal function,blood glucose and homocysteine and other indicators,asked in detail whether the history of diabetes,history of hypertension and smoking and drinking history,And the carotid artery color Doppler ultrasonography was used to examine the changes of carotid artery inner thickness(IMT),plaque formation and plaque,and the degree of carotid atherosclerosis and stenosis were evaluated comprehensively.Results The patients were divided into normal group,IMT thickening group,plaque formation group and moderate to severe stenosis group.The normal carotid artery group was defined as the control group.The plasma homocysteine The relationship between plasma Hcy levels and carotid atherosclerosis and stenosis was studied.The correlation between other factors and carotid atherosclerosis was analyzed by nonparametric test.Finally,multiple linear regression analysis was used to exclude the relationship between plasma Hcy levels and carotid atherosclerosis and stenosis.Other factors were identified to determine which factors were an independent risk factor for predicting carotid atherosclerosis.All the data were analyzed by SPSS22.0 software package,all the analysis results were P <0.05 for the difference was statistically significant.Results: 1 The age and smoking of patients with carotid atherosclerosis was significantly higher than that of the control group.There was significant difference between the two groups(P<0.05).2 The level of homocysteine(Hcy)in patients with carotid atherosclerosis was significantly higher than that in the control group and was positively correlated with carotid atherosclerosis and stenosis.3 The levels of uric acid(UA)in patients with carotid atherosclerosis were significantly higher than those in the control group(P<0.05),and the levels of serum high sensitive C reactive protein(HSCRP)were significantly higher in patients with carotid atherosclerosis,P<0.05,the difference was statistically significant.4 The blood Hcy level in male patients was significantly higher than that in female patients(P<0.05).The Hcy of smokers was significantly higher than that of non-smokers(P<0.05),and the difference was statistically significant(P<0.05).5 After adjusting for the influence of factors such as sex,age,hypertension,diabetes,cholesterol,triglyceride,low density lipoprotein,homocysteine,uric acid,high-sensitivity C-reactive protein and so on,gender,age,homocysteine and high sensitivity C-reactive protein is an independent risk factor for predicting carotid atherosclerosis and stenosis.Conclusions:1 Plasma homocysteine levels were positively correlated with carotid atherosclerosis and stenosis,and the higher the plasma Hcy level,the more severe the carotid atherosclerosis and stenosis.2 Plasma homocysteine can be used as an independent risk factor for predicting carotid atherosclerosis and stenosis after adjusting for gender,age,hypertension,diabetes,CHOL,TG,LDL,Hcy,UA,HSCRP and other factors.