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The Effects of Plasma Homocysteine Concentration on Upper Arm-Ankle Pulse Wave Velocity

혈장 호모시스테인 농도가 상완-발목 맥파 속도에 미치는 영향

  • Kang, Ji-Hun (Dept. of Emergency Medicine, Inje University Busan Paik Hospital) ;
  • Shin, Sang-Yol (Dept. of Emergency Medical Service, Howon University)
  • 강지훈 (부산백병원 응급의학과) ;
  • 신상열 (호원대학교 응급구조학과)
  • Received : 2018.08.14
  • Accepted : 2019.02.01
  • Published : 2019.02.28
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Abstract

This study was conducted to investigate the effects of plasma homocysteine concentration on the brachial-ankle pulse wave velocity between the normal homocysteine group and the asymptomatic high homocysteine group. 435 subjects who visited the general health examination center from April 1 to October 31, 2016, as well as to compare the direct correlation of the brachial-ankle pulse wave velocity, which indirectly reflects the homocysteine test and arterial stiffness, as a predictor of future cardiovascular outcome. As a result of the study, age, waist circumference, BUN, and plasma creatinine were significantly higher, and HDL was significantly lower in the high homocysteine group (> $15{\mu}mol/L$) than in the normal homocysteine group (< $15{\mu}mol/L$) (p=0.05). In addition, homocysteinemia was associated with smoking and drinking (p<0.001) and was significantly higher in males (p<0.001). The right and left brachial-to-ankle pulse wave velocities were significantly higher in the high homocysteine group (right p<0.001, left p=0.003) before calibrating the relevant variables. There was no significant difference between right and left brachial-to-ankle pulse wave velocities after calibrating the relevant variables. Therefore, further studies on the independent association of lowering homocysteine concentration and prevention of cardiovascular disease and the relationship between homocysteine and renal function are needed.

본 연구는 2016년 4월 1일부터 2016년 10월 31일까지 종합병원 건강검진센터에 내원한 435명을 대상으로 혈장 호모시스테인 농도가 정상 호모시스테인 군과 무증상 고호모시스테인 군 간에 발목-상완 pulse wave velocity에 유의한 차이가 있는지를 비교해 심혈관 질환 발생의 향후 예측인자로서 호모시스테인 검사와 동맥의 경직도를 간접적으로 반영하는 상완-발목 pulse wave velocity의 직접적인 상호 연관성을 비교해보고자 시도되었다. 연구결과 고 호모시스테인혈증 군에서 정상 호모시스테인 군에 비해 연령, 허리둘레, BUN, 혈장 크레아티닌이 유의하게 높았고, HDL은 유의하게 낮았다. 또한, 고 호모시스테인혈증은 흡연 및 음주 여부와 관련이 있었으며, 남성에서 유의하게 많았다. 관련 변수를 보정하기 전에는 고 호모시스테인 군에서 우측 및 좌측 상완-발목 맥파 속도가 유의하게 높았으나 관련 변수를 보정한 후에는 두 군의 상완-발목 맥파 속도는 유의한 차이를 보이지 않았다. 따라서, 향후 국내 수검자를 대상으로 호모시스테인 농도를 낮추는 중재적 치료 후 심혈관질환 예방에 대한 독립적 연관성 및 호모시스테인과 신장 기능의 관련성에 대한 추가 연구가 필요하겠다.

Keywords

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Fig. 1. study flow diagram

Table 1. Characteristics of the population according to hyperhomocysteinemia status

SHGSCZ_2019_v20n2_673_t0001.png 이미지

Table 2. The Relationship between brachial-ankle pulse wave velocity and other variables

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Table 3. Mean brachial-ankle pulse wave velocity difference and ankle-brachial index difference between the two groups before and after multivariate adjustment

SHGSCZ_2019_v20n2_673_t0003.png 이미지

Table 4. Relationship between serum homocysteine level and brachial-ankle pulse wave velocity

SHGSCZ_2019_v20n2_673_t0004.png 이미지

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