LOGISTIC REGRESSION ANALYSIS ON RELATIONSHIP OF SERUM HOMOCYSTEINE, FOLIC ACID, AND VITAMIN B12 WITH CORONARY ARTERIOPATHY

摘要

Objective To investigate the relationship among the serum homocysteine (Hcy), folic acid and vitamin B12 with coronary arteriopathy.Methods In a cross-sectional study, serum Hcy levels of 210 cases with (CHD), 115 non CHD subjects from a consecutive series of subjects with chest pain or myocardial infarction(MI) undergoing diagnostic coronary angiography and 63 subjects undergoing health examination were measured using high-performance liquid chromatography (HPLC) with fluorescence detection. Serum folic acid and vitamin B12 level were measured by radioimmunoassay method. Serum cholesterol and lipoproteins were also measured. The information on conventional risk factors were collected by interviews.Results The coronary arteriopathy was correspondingly related with male, smoking, diabetes, folic acid, vitamin B12, ApoA1, and Hcy level. The mean serum Hcy level were significantly higher in CHD patients than in non CHD patients(19.01±10.36 μmol/L n=210 vs 11.5+4.97 μmol/L n=115, P0.01). The mean serum folic acid level and vitamin B12 level were significantly lower in CHD patients (4.5±1.5 pg/ml vs 414.6±142.3 pg/ml) than in non CHD patients (5.6±1.4ng/ml vs 537.7±136.6 ng/ml), P0.01. There is no difference on the mean serum Hcy level in NCHD cases and the healthy subjects. The mean serum ApoA1 (1188.8±206.1 mmol/L vs 1262.1±201.4 mmol/L)level was significantly lower in CHD patients than in non CHD patients, P0.05. CHD patients had higher rates of smoking, aging and suffering from diabetes than non CHD patients. By multivariate logistic regression, the OR of Hcy, aging, male and diabetes were all≥1, P0.01, which means all these factors are independent risk factors. With forward method, when folic acid, vitamin B12 and Hcy entering the regression model, the coefficients of Hcy changed greatly, showed multivariate co-liner on logistic regression.Conclusion The results of our study showed that Hcy, male, senility and diabetes were all independent risk factors in the development of arteriopathy. Hcy, vitamin B12 and folic acid have similar effects on the development of arteriopathy. Elevated serum Hcy level is a more stable index than serum lipids.