摘要
目的分析浙江省汉族人群血清同型半胱氨酸(homocysteine,Hcy)、叶酸、维生素B_(12)(vitamin B_(12),VitB_(12))水平和溃疡性结肠炎(ulcerative colitis,UC)临床特征的相关性。方法纳入186例UC患者和202例性别与年龄相匹配的正常对照者,采用“Truelove&Witts”评分评估UC患者的疾病活动度。应用循环酶法测定Hcy水平,化学发光免疫法测定叶酸、VitB_(12)水平。运用Pearson相关性分析、多元线性回归分析探讨UC患者Hcy水平与“Truelove&Witts”评分、叶酸、VitB_(12)、C反应蛋白、血清白蛋白等实验室指标的关系。采用Logistic回归法评估UC独立危险因素。结果与正常对照组比较,UC组中Hcy水平显著高于正常对照组(13.01±4.02μmol/L vs 10.01±2.40μmol/L,P<0.01),而叶酸、VitB_(12)水平均明显低于正常对照组(5.74±2.64ng/ml vs 7.59±2.21ng/ml,P<0.01;274.49±115.12pg/ml vs 429.85±120.92pg/ml,P<0.01)。UC组中高同型半胱氨酸血症(high homocysteine,HHcy,>15.0μmol/L)和叶酸缺乏(<4.0ng/ml)、VitB_(12)缺乏(<203.0pg/ml)的比例均明显升高(24.19%vs 5.94%,P<0.01;27.96%vs 5.44%,P<0.01;29.57%vs 6.93%,P<0.01),且UC患者中Hcy水平重度>中度>轻度(15.27±4.73μmol/L vs 12.45±3.64μmol/L vs 9.32±2.27μmol/L,P均<0.01),而叶酸、VitB_(12)水平均重度<中度<轻度(4.26±2.89ng/ml vs 6.03±2.50ng/ml vs 7.14±2.37ng/ml,P均<0.01;198.37±98.64pg/ml vs 316.58±134.37pg/ml vs 402.17±130.61pg/ml,P均<0.01)。多因素Logistic回归分析表明,在校正性别和年龄等因素后,UC组中Hcy水平与叶酸、VitB_(12)水平呈独立负相关(β=-0.287,P=0.025;β=-0.267,P=0.032),多因素Logistic回归分析结果显示,叶酸缺乏、VitB_(12)缺乏均为UC的独立危险因素(OR=3.314,P=0.012;OR=7.019,P<0.01)。结论浙江省汉族UC患者中高同型半胱氨酸血症和叶酸、VitB_(12)缺乏的情况可能普遍存在,血清Hcy水平和叶酸、VitB_(12)水平与UC患者疾病严重程度密切相关,叶酸、VitB_(12)缺乏均为UC的独立危险�
Objective To analyze the correlation between serum homocysteine(Hcy),folic acid,vitamin B_(12)(VitB_(12))levels and clinical features of ulcerative colitis(UC)in Zhejiang Han population.Methods A total of 186 UC patients and 202healthy controls with matched gender and age were enrolled to evaluate the disease activity of UC patients by"Truelove&Witt"score.The levels of Hcy and folic acid and VitB_(12) were detected by cyclic enzyme assay and chemiluminescence immunoassay.Pearson correlation analysis and multiple linear regression analysis were used to analyze the relationship between Hcy level,"Truelove&Witt"score,folic acid,VitB_(12),C-reactive protein and serum albumin in UC patients.Finally,the independent risk factors of UC were assessed by Logistic regression analysis.Results Compared with the normal control group,the level of Hcy in UC group was significantly higher than that in the normal control group(13.01±4.02μmol/L vs 10.01±2.40μmol/L,P<0.01),folic acid and VitB_(12) levels were significantly lower than those in the control group(5.74±2.64ng/ml vs 7.59±2.21ng/ml,P<0.01;274.49±115.12pg/ml vs 429.85±120.92pg/ml,P<0.01).The ratios of hyperhomocysteine(HHcy)in UC group(>15.0μmol/L),folic acid deficiency(<4.0ng/ml)and VitB_(12) deficiency(<203.0pg/ml)were statistically increased in UC patients than in controls(24.19%vs 5.94%,P<0.01;27.96%vs 5.44%,P<0.01;29.57%vs 6.93%,P<0.01).The level of Hcy was increased with the severity of UC which was severe UC>moderate UC>mild UC(15.27±4.73μmol/L vs 12.45±3.64μmol/L vs 9.32±2.27μmol/L,P<0.01).And the levels of folic acid and VitB_(12) was decreased with the severity of UC which was severe UC<moderate UC<mild UC(4.26±2.89ng/ml vs 6.03±2.54ng/ml vs 7.14±2.37ng/ml,P<0.01;198.37±98.64pg/ml vs 316.58±134.37pg/ml vs 402.17±130.61pg/ml,P<0.01).After adjusting for gender and age,multivariate Logistic regression analysis showed that Hcy level was negatively correlated with folic acid and VitB_(12) in UC group(β=-0.287,P=0.025;β=-0.267,P=0.032).Multivaria
作者
邵晓晓
史睿昕
朱浩奇
蒋益
SHAO Xiaoxiao;SHI Ruixin;ZHU Haoqi(The Second Affiliated Hospital&Yuying Children′s Hospital,Zhejiang 325000,China)
出处
《医学研究杂志》
2022年第10期52-55,38,共5页
Journal of Medical Research
基金
浙江省自然科学基金资助项目(LY18H030009,LY17H030011)
浙江省中医药基金资助项目(2019ZB075)
浙江省温州市科技计划项目(Y2020285)
贺林院士工作站科研基金资助项目(19331101,19331104)。
