切换至 "中华医学电子期刊资源库"

中华老年病研究电子杂志 ›› 2016, Vol. 03 ›› Issue (01) : 30 -38. doi: 10.3877/cma.j.issn.2095-8757.2016.01.007

所属专题: 文献

综述

同型半胱氨酸与H型高血压研究进展
张宇1, 王林1,()   
  1. 1. 300211 天津医科大学第二医院干部保健科
  • 收稿日期:2016-01-15 出版日期:2016-02-28
  • 通信作者: 王林

Research progress of homocysteine and H type hypertension

Yu Zhang1, Lin Wang1()   

  1. 1. Cadre Health Department, the Second Hospital of Tianjin Medical University, Tianjin 30021, China
  • Received:2016-01-15 Published:2016-02-28
  • Corresponding author: Lin Wang
引用本文:

张宇, 王林. 同型半胱氨酸与H型高血压研究进展[J]. 中华老年病研究电子杂志, 2016, 03(01): 30-38.

Yu Zhang, Lin Wang. Research progress of homocysteine and H type hypertension[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2016, 03(01): 30-38.

同型半胱氨酸(homocysteine,Hcy)自20世纪30年代被发现以来,其在高血压、心脑血管疾病、免疫疾病以及肿瘤疾病中的致病作用被越来越多的研究证实。H型高血压患者心脑血管并发症发生率较普通高血压患者高。近年来,H型高血压患者调节性T细胞/辅助性T细胞引起免疫失调进而导致脑损伤的研究已成为临床关注热点。本文将对Hcy、Hcy血症(hyperhomocysteinemia,HHcy)、H型高血压、H型高血压合并脑梗死以及伴有HHcy的高血压患者的脑损伤免疫机制和预防措施进行综述。

The pathogenic mechanism of homocysteine (Hcy) in hypertension, cardiovascular diseases, cerebral diseases, autoimmune diseases and tumor have been proved since Hcy was found in 1930s. Patients with H-type hypertension have higher chances to get the cardiovascular and cerebral complications. The pathogenesis of Treg / Th cells in H type hypertension to promote cerebral injury has been focused recently. Here we reviewed the immune mechanisms and prevention strategy of Hcy, HHcy, H-type hypertension, H-type hypertension complicated with cerebral infarction.

图1 Hcy代谢示意图
图2 Hcy代谢及MTHFR作用示意图
图4 叶酸代谢过程示意图
[1]
Spence JD. Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke[J]. Nutr Res, 2016, 36(2): 109-116.
[2]
McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis[J]. Am J Pathol, 1969, 56(1): 111-128.
[3]
McCully KS, Ragsdale BD. Production of arteriosclerosis by homocysteinemia[J].Am J Pathol, 1970, 61(1):1-11.
[4]
顼志兵,汪卫东,张莉芬,等.银杏叶胶囊对高同型半胱氨酸血症血管内皮细胞凋亡干预的实验研究[J].中国中西医结合杂志,2015,35(9): 1099-1104.
[5]
Clarke R, Halsey J, Lewington S, et al. Effects of lowering homocysteine levels with b vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving 37485 individuals[J]. Arch Intern Med, 2010, 170(18): 1622-1631.
[6]
Xanthakis V, Enserro DM, Murabito JM, et al. Ideal cardiovascular health: associations with biomarkers and subclinical disease and impact on incidence of cardiovascular disease in the Framingham Offspring Study[J]. Circulation, 2014, 130(19): 1676-1683.
[7]
Dong C, Rundek T, Wright CB, et al. Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and Hispanics: the Northern Manhattan Study[J]. Circulation, 2012, 125(24): 2975-2984.
[8]
Antoniades C, Antonopoulos AS, Tousoulis D, et al. Homocysteine and coronary atherosclerosis: from folate fortification to the recent clinical trials[J]. Eur Heart J, 2009, 30(1): 6-15.
[9]
Catena C, Colussi G, Nait F, et al. Elevated homocysteine levels are associated with the metabolic syndrome and cardiovascular events in hypertensive patients[J]. Am J Hypertens, 2015, 28(7): 943-950.
[10]
Wang W, Rusin O, Xu X, et al. Detection of homocysteine and cysteine[J]. J Am Chem Soc, 2005, 127(45): 15949-15958.
[11]
Armitage J, Bowman L, Wallendszus K, et al. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: a double-blind randomised trial[J]. Lancet, 2010, 376(9753): 1658-1669.
[12]
Głowacki R, Stachniuk J, Borowczyk K, et al. Quantification of homocysteine and cysteine by derivatization with pyridoxal 5'-phosphate and hydrophilic interaction liquid chromatography[J]. Anal Bioanal Chem, 2016, 408(7): 1935-1941.
[13]
Zhang W, Li P, Geng Q, et al. Simultaneous determination of glutathione, cysteine, homocysteine, and cysteinylglycine in biological fluids by ion-pairing high-performance liquid chromatography coupled with precolumn derivatization [J]. J Agric Food Chem, 2014, 62(25): 5845-5852.
[14]
Adaikalakoteswari A, Webster C, Goljan I, et al. Simultaneous detection of five one-carbon metabolites in plasma using stable isotope dilution liquid chromatography tandem mass spectrometry[J]. J Chromatogr B Analyt Technol Biomed Life Sci, 2016, 1012-1013: 186-192.
[15]
Barve A, Lowry M, Escobedo J, et al. Fluorescein tri-aldehyde promotes the selective detection of homocysteine [J]. J Fluoresc, 2016[Epub ahead of print].
[16]
Yu L, Li L, Ding Y, et al. A fluorescent switch sensor for glutathione detection based on mn-doped cdte quantum dots - methyl viologen nanohybrids[J]. J Fluoresc, 2016[Epub ahead of print].
[17]
Li WX, Lv WW, Dai SX, et al. Joint associations of folate, homocysteine and MTHFR, MTR and MTRR gene polymorphisms with dyslipidemia in a Chinese hypertensive population: a cross-sectional study[J]. Lipids in Health and Disease, 2015, 14: 101.
[18]
王佳,王淑玲,曾丹,等.亚甲基四氢叶酸还原酶C677T基因多态性与H型高血压及同型半胱氨酸水平升高的相关性研究[J].中国脑血管病杂志,2015,129(11): 581-586.
[19]
黄敏,鲁衍强,薛琰,等.佛山市南海区汉族女性MTHFR、MTRR基因型和等位基因频率分布及与其他地区汉族女性的比较[J].中国妇幼保健,2016,31(2): 310-313.
[20]
Gasparovic J, RaslováK, BasistováZ, et al. Effect of C677T methylenetetrahydrofolate reductase gene polymorphism on plasma homocysteine levels in ethnic groups[J]. Physiol Res, 2004, 53(2): 215-218.
[21]
Krajcovicová-KudláckováM, Blazícek P, Ginter E, et al. Homocysteine and its nutritional determinants in two ethnic groups of Slovakia[J]. Cent Eur J Public Health, 2004, 12(4): 217-219.
[22]
Lopez JB, Peng CL. Plasma homocysteine reference values of adult Malaysians from three ethnic groups[J]. Clin Chim Acta, 2004, 340(1-2): 235-238.
[23]
Mejia Mohamed EH, Tan KS, Ali JM, et al. TT genotype of the methylenetetrahydrofolate reductase C677T polymorphism is an important determinant for homocysteine levels in multi-ethnic Malaysian ischaemic stroke patients[J]. Ann Acad Med Singapore, 2011, 40(4): 186-191.
[24]
李理,汤哲.老年H型高血压的流行病学研究进展[J].中华流行病学杂志,2014,35(9): 1075-1077.
[25]
Clarke R, Stansbie D. Assessment of homocysteine as a cardiovascular risk factor in clinical practice [J]. Ann Clin Biochem, 2001, 38:624-632.
[26]
Zhong C, Lv L, Liu C, et al. High homocysteine and blood pressure related to poor outcome of acute ischemia stroke in Chinese population[J]. PLoS One, 2014, 29(9): e107498.
[27]
Tayama J, Munakata M, Yoshinaga K, et al. Higher plasmahomocysteine concentration is associated with more advanced systemic arterial stiffness and greater blood pressure response to stress in hypertensive patients[J].Hypertens Res, 2006, 29(6): 403-409.
[28]
马红妮,颜飞,李再利,等.社区脑卒中高危人群同型半胱氨酸水平与认知功能调查[J].中华流行病学杂志,2014,35(7): 769-772.
[29]
张秀洲,刘福艳,李静,等.血管内皮功能和同型半胱氨酸对老年冠心病患者发病的相关性探讨[J].中华老年心脑血管病杂志,2015,17(12): 1268-1270.
[30]
Liu T, Lin J, Ju T, et al. Vascular smooth muscle cell differentiation to an osteogenic phenotype involves matrix metalloproteinase-2 modulation by homocysteine[J]. Mol Cell Biochem, 2015, 406(1-2): 139-149.
[31]
马剑平,陈忠伟,陈思韩,等.高血压患者同型半胱氨酸与卒中关系的前瞻性研究[J].中华内科杂志,2015,54(4): 296-301.
[32]
Chen CH, Yang WC, Hsiao YH, et al. High homocysteine, low vitamin B-6, and increased oxidative stress are independently associated with the risk of chronic kidney disease[J]. Nutrition, 2016, 32(2): 236-241.
[33]
Holmes MV, Newcombe P, Hubacek JA, et al. Effect modification by population dietary folate on the association between MTHFR genotype, homocysteine, and stroke risk: a meta-analysis of genetic studies and randomised trials[J]. Lancet, 2011, 378(9791): 584-594.
[34]
Holmes MV, Newcombe P, Hubacek JA, et al. Effect modification by population dietary folate on the association between MTHFR genotype, homocysteine, andstroke risk: a meta-analysis ofgenetic studies and randomised trials[J]. Lancet, 2011, 378(9791): 584-594.
[35]
Zhang W, Sun K, Chen J, et al. High plasma homocysteine levels contribute to the risk of stroke recurrence and all-causemortality in a large prospective stroke population[J].Clin Sci(Lond), 2009, 118(3): 187-194
[36]
何方园,张红,胡萌萌,等.调节性T细胞与Th17细胞相关因子在实验性自身免疫性肌炎小鼠淋巴结中的表达及意义[J].细胞与分子免疫学杂志,2014,30(4): 399-402.
[37]
Harris TJ, Grosso JF, Yen HR, et al. An in vivo requirement for STAT3 signaling in TH17 development and TH17-dependent autoimmunity[J]. Journal of Immunology, 2007, 179(7): 4313–4317.
[38]
Zhang Y, Jie G, Wang L, et al. The immunomodulatory mechanism of brain injury induced by homocysteine in spontaneously hypertensive rats[J]. Journal of oncology letters, 2016[Epub ahead of print].
[39]
Qin X, Huo Y, Wang J, et al. Efficacy of folic acid supplementation in stroke prevention: new insight from a meta-analysis[J]. Int J Clin Pract, 2012, 66(6): 544-551.
[40]
Qin X, Huo Y. H-Type hypertension, stroke and diabetes in China: Opportunities for primary prevention[J].J Diabetes, 2016, 8(1): 38-40.
[41]
付丽,程洁.马来酸依那普利叶酸片对老年慢性心力衰竭患者血清和肽素N-末端B型脑利钠肽前体及同型半胱氨酸水平的影响研究[J].实用心脑肺血管病杂志,205,23(11): 59-61.
[42]
许榕仙,詹美蓉,范岩峰.叶酸、VB6、VB12对糖尿病患者同型半胱氨酸水平的影响[J].营养学报,2008,30(3): 234-237.
[43]
李玉华,白吉明.马来酸依那普利叶酸片在伴有同型半胱氨酸升高型高血压病患者治疗中的作用评估[J].河北医学,2015,22(7): 1137-1139.
[44]
Clarke R, Halsey J, Lewington S, et al. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: meta-analysis of 8 randomized trials involving37485 individuals[J]. Arch Intern Med, 2010, 170(18): 1622-1631.
[45]
BakerF, Picton D, Blackwood S, et al. Blinded comparison of folic acid and placebo in patients with ischaemic heart disease: an outcome trial[J]. Circulation, 2002, 106: 741S.
[46]
Jamison RL, Hartigan P, Kaufman JS, et al. Effect of homocysteine lowering on mortality and vascular disease in advanced chronic kidney disease and end stage renal disease: a randomized controlled trial[J]. JAMA, 2007, 298(10): 1163-1170.
[47]
Ebbing M, BleieØ, Ueland PM, et al. Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography: a randomized controlled trial[J]. JAMA, 2008, 300(7): 795-804.
[48]
Toole JF, Malinow MR, Chambless LE, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP)randomized controlled trial[J]. JAMA, 2004, 291(5): 565-575.
[49]
Bnaa KH, Njlstad I, Ueland PM, et al. Homocysteine lowering and cardiovascular events after acute myocardial infarction[J].N Engl J Med, 2006, 354(15): 1578-1588.
[50]
Albert CM, Cook NR, Gaziano JM, et al. Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial[J]. JAMA, 2008, 299(17): 2027-2036.
[51]
Lonn E, Arnold MJ. Homocysteine lowering with folic acid and B vitamins in vascular disease[J]. N Engl J Med, 2006, 354(15): 1567-1577.
[52]
Armitage JM, Bowman L, Clarke RJ, et al. Effects of homocysteine-lowering with folic acid plus vitamin B12 vs placebo on mortality and major morbidity in myocardial infarction survivors: a randomized trial[J]. JAMA, 2010, 303(24): 2486-2494.
[53]
Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis [J]. JAMA, 2002, 288(16): 2015-2022.
[54]
Carnicer R, Navarro A, Arbonqs-Mainar JM, et al. Folic acid supplementation delays atherosclerotic lesion development in apoE-deficient mice[J]. Life Sci, 2002, 80(7): 638-643.
[55]
Yvo M, Smulders&Henk JB. The homocysteine controversy[J]. J Inherit Metab Dis, 2011, 34(1): 93-99.
[56]
Figueiredo JC, Grau MV, Haile RW, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial[J]. J Natl Cancer Inst, 2009, 101: 432-435.
[57]
Giles WH, Kittner SJ, Croft JB, et al. Serum folate and risk for coronary heart disease: results from a cohort of US adults[J]. Ann Epidemiol, 1998, 8(8): 490-496.
[58]
Hansson GK. Inflammation, atherosclerosis, and coronary artery disease[J]. N Engl J Med, 2005, 352(16): 1685-1695.
[59]
Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes[J]. N Engl J Med, 2008, 359(15): 1577-1589.
[60]
Troen AM, Mitchell B, Sorensen B, et al. Unmetabolized folic acid in plasma is associated with reduced natural killer cell cytotoxicity among postmenopausal women[J]. J Nutr, 2006,136(1): 189-194.
[61]
Halm VP, Nurmohamed MT, Twisk JW, et al. Disease-modifying antirheumatic drugs are associated with a reduced risk for cardiovascular disease in patients with rheumatoid arthritis: a casecontrol study[J]. Arthritis Res Ther, 2007, 8(5): R151.
[62]
Wang X, Qin X, Demirtas H, et al. Efficacy of folic acid supplementation in stroke prevention: a metaanalysis[J]. Lancet, 2007, 369(9576): 1876-1882.
[63]
Xia W, Hilgenbrink AR, Matteson EL, et al. A functional folate receptor is induced during macrophage activation and can be used to target drugs to activated macrophages[J]. Blood, 2009, 113(2): 438-446.
[64]
Yi P, Melnyk S, Pogribna M, et al. Increase in plasma homocysteine associated with parallel increases in plasma s-adenosylhomocysteine and lymphocyte dna hypomethylation[J]. J Biol Chem, 2000, 275(38): 29318-29323.
[65]
Zhao R, Matherly LH, Goldman ID. Membrane transporters and folate homeostasis: intestinal absorption and transport into systemic compartments and tissues[J]. Expert Rev Mol, 2009, 11: e4.
[66]
Smulders YM, Smith DEC, Kok RM, et al.Red blood cell folate vitamer distribution in healthy subjects is determined by the methylenetetrahydrofolate reductase C677T polymorphism and by total folate status[J].J Nutr Biochem, 2007, 18(10): 693-699.
[1] 徐珂莹, 归崎峰, 杨云梅. 老年人群血清胱抑素C、同型半胱氨酸与脑白质疏松症的相关性研究[J]. 中华危重症医学杂志(电子版), 2020, 13(01): 34-38.
[2] 刘绪义, 秦琦, 辛亚兰, 鲁衍强, 胡季芳. 妊娠期血清同型半胱氨酸浓度与MTHFR基因C677T位点多态性及红细胞叶酸水平的相关性分析[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(03): 362-367.
[3] 刘婷, 伍晓玲, 杨明福. 叶酸联合甲钴胺治疗对COPD稳定期伴高Hcy血症患者氧化应激、炎症因子及肺功能的影响[J]. 中华肺部疾病杂志(电子版), 2020, 13(01): 59-62.
[4] 李松, 章陈晨, 宋双双. H型高血压合并冠心病患者外周血中EMMPRIN、ADMA、Hcy、MMPs、Treg和Th17细胞水平检测[J]. 中华细胞与干细胞杂志(电子版), 2019, 09(04): 206-210.
[5] 庞慧, 纵振坤, 付强, 曹秋玫, 郝林. 同型半胱氨酸对高血压患者脑卒中复发风险的影响[J]. 中华神经创伤外科电子杂志, 2019, 05(03): 134-139.
[6] 许秀兰, 朱建建. 血压变异性与伴H型高血压的急性脑梗死患者预后不良的临床关系分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(04): 199-204.
[7] 王淑珍, 王洪生, 王立志, 李英杰. 高同型半胱氨酸血症的发生机制及其病理生理学意义[J]. 中华脑科疾病与康复杂志(电子版), 2019, 09(02): 117-120.
[8] 庞慧, 纵振坤, 付强, 刘怡, 郝林. H型高血压脑卒中复发风险的性别差异[J]. 中华脑科疾病与康复杂志(电子版), 2019, 09(02): 69-74.
[9] 蔡琦, 雍永宏, 何花, 佘铜生, 俞慧. 三维斑点追踪技术联合血清同型半胱氨酸对冠心病患者左心功能的评估价值[J]. 中华临床医师杂志(电子版), 2022, 16(05): 425-430.
[10] 李彩梅, 丁晓春. 小于胎龄儿出生后血清维生素B12及脑发育水平研究[J]. 中华临床医师杂志(电子版), 2020, 14(05): 370-375.
[11] 蔺曜, 黄晓玲, 何昭霞, 牟博勇, 牟燕. 血浆同型半胱氨酸水平对女性高血压患者冠状动脉病变的预测价值[J]. 中华诊断学电子杂志, 2022, 10(01): 48-52.
[12] 陆晓玲, 钦光跃, 黄勍栋, 唐婷玉, 杜坚宗. 老年重度阻塞性睡眠呼吸暂停综合征患者同型半胱氨酸水平与认知功能的关系[J]. 中华老年病研究电子杂志, 2019, 06(02): 40-43.
[13] 吴艳平, 刘小北, 黄龚春, 高慧慧, 舒勤奋. 浙江平湖地区城乡人群血浆同型半胱氨酸水平及相关因素分析[J]. 中华老年病研究电子杂志, 2018, 05(04): 25-28.
[14] 王阿妮, 马英东, 王梁, 马亮, 金莉子. 血清高同型半胱氨酸水平对心衰患者再发心功能不全的预测价值[J]. 中华卫生应急电子杂志, 2021, 07(02): 83-85.
[15] 晏僖, 尚俊奎, 王凤羽, 秦晓明, 霍雪静, 刘锐杰, 邹金龙, 张杰文. 同型半胱氨酸及凝血-纤溶指标与脑小血管病的关系[J]. 中华脑血管病杂志(电子版), 2022, 16(01): 27-31.
阅读次数
全文


摘要