Study On Plasma Homocysteine Level And Its Clinical Significance In Patients With Chronic Comorbidities In General Practice Department

Objective: To analyze the plasma homocysteine level and distribution characteristics of patients with chronic disease comorbidities in general practice department,and explore the correlation between plasma homocysteine and the type and quantity of chronic disease comorbidities,with a view to clarifying the clinical significance of plasma homocysteine level in the management of patients with chronic disease comorbidities in general practice department.Methods: A retrospective study was carried out on 505 patients with chronic comorbidities included in the Department of General Practice of the First Affiliated Hospital of China Medical University from January 1,2019 to December 31,2022.The general data of the patients were collected,including age,sex,BMI,disease history and other clinical data,as well as carotid artery color Doppler ultrasound and laboratory serology,including homocysteine,triglyceride,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol.The plasma homocysteine level and its distribution characteristics in different sex,age and body mass of the enrolled subjects were analyzed.At the same time,the related factors were included as independent variables for multiple linear regression analysis to analyze the action direction of the influencing factors,and to explore the correlation between the level of homocysteine and the number of comorbidity of six chronic diseases(hypertension,type 2 diabetes,coronary heart disease,dyslipidemia,ischemic cerebrovascular disease,osteoporosis),which are the focus of this study.This study uses IBM SPSS19.0 statistical software.Results:1.Homocysteine level and distribution characteristics of inpatients with chronic disease comorbidities:In 505 study samples,the average plasma homocysteine level was(11.31 ± 4.77)umol/L,of which 242 cases(47.9%)had normal homocysteine level and 263 cases(52.1%)had elevated homocysteine level.Among the patients with elevated homocysteine level,the level of homocysteine increased slightly in 201 cases(76.4%),moderately in 59 cases(22.4%),and severely in 3 cases(1.2%).Gender comparison: There is a statistically significant difference in plasma Hcy levels between female and male(p<0.05).Comparison of different age groups: The difference of plasma Hcy level among the young,middle,old age groups was statistically significant(p<0.05),and there was a positive correlation between age and Hcy level(r=0.160,p<0.01).The difference of plasma Hcy level between female and male patients in the young and middle age groups was statistically significant(p<0.05),while the difference of plasma Hcy level between female and male patients in the old age group was not statistically significant(p>0.05).Comparison of different body mass index groups: The difference of plasma Hcy level among the three groups of normal body mass index group,super mass index group and obesity group was statistically significant(p<0.05),and there was a positive correlation between plasma Hcy and BMI(r=0.113,p<0.01).The difference of plasma Hcy level between normal body mass index group and super mass index group was statistically significant(p<0.05),while the difference of plasma Hcy level between obesity group and other two groups was not statistically significant(p>0.05).Multivariate linear regression analysis of influencing factors of Hcy level:The level of HDL-C and age were significantly correlated with the plasma homocysteine level of the enrolled subjects,in which HDL-C was negatively correlated with the level of Hcy,that is,the level of Hcy decreased with the increase of HDL-C,and age was positively correlated with the level of Hcy,that is,the level of Hcy increased with the increase of age(p<0.05).2.Correlation analysis between chronic disease and plasma Hcy level:The difference between the score of carotid artery and the number of chronic diseases in the group with normal plasma Hcy level and the group with high plasma Hcy level was statistically significant(p<0.05),and there was a correlation between both the number of chronic diseases and the score of carotid artery with the plasma Hcy level(r=0.102,p<0.05;r=0.165,p<0.05).In the group with normal plasma homocysteine level,7.0%,19.8%,26.8% and 46.4% of the patients with no chronic disease subgroup,one chronic disease subgroup,two chronic disease subgroups,and three or more chronic disease subgroups respectively.In the group with elevated plasma homocysteine level,4.9%,14.4%,25.1% and 55.6% of the patients with no chronic disease subgroup,one chronic disease subgroup,two chronic disease subgroups,and three or more chronic disease subgroups respectively.(Note: Uncomplicated chronic diseases refer to that are not combined with the six chronic diseases discussed in this study,but may combine with two or more chronic diseases such as COPD,bronchial asthma,anxiety,cervical spondylosis,and joint pain;Patients with one chronic disease refer to patients with one or more chronic diseases such as COPD,bronchial asthma,anxiety disorder,cervical spondylosis,joint pain and one of the chronic diseases discussed in this study).There was a statistically significant difference in the percentage of patients with chronic diseases between the group with normal plasma homocysteine level and the group with high plasma homocysteine level(p<0.05).There was a statistically significant difference in the percentage of patients with three or more chronic diseases combined between the group with normal plasma homocysteine level and the group with high plasma homocysteine level(p<0.05).Conclusion: 1.The proportion of chronic comorbidities patients in general medical department with high Hcy is more,but the proportion of patients with severe increase is relatively less,which may be related to the fact that the common health problems in general practice department are relatively stable chronic diseases.2.The level of Hcy in men is higher than that in women.The body mass index and age are positively correlated with the level of Hcy.3.Age,HDL-C level are the factors that affect the plasma homocysteine level of inpatients with chronic disease.4.There is a correlation between plasma homocysteine level and the condition and development of patients with chronic disease.