The Effect Of Plasma Homocysteine Level On Carotid Atherosclerosis And Risk Factors Of ASCVD High Risk Residents In Rural Changsha

Objective Investigation of Changsha City rural residents atherosclerotic cardiovascular disease mentioned above cardiovascular disease, ASCVD) in patients with high risk of plasma homocysteine(Hcy) level; observe the influence of Hyperhomocysteinemia(HHcy) on the occurrence and development of carotid atherosclerosis, and to analyze the possible risk factors of HHcy.Methods In January November 2014 to 2015, relying on the year 2014 State Planning Commission stroke prevention and screening programs, by cluster sampling method, respectively extraction of Changsha county Huang Xing Zhen Lan Tian Xin Cun and fairy city village, age over 40 years old(including 40 years) residents(residence time is equal to or more than half a year) for screening. 2014 population of Hunan Province Bureau of Statistics Census data based on, according to the census data in accordance with the population age and residency requirements to get the complete survey data,the sampling rate of must be in 85% above(the State Planning Commission cerebral stroke prevention and screening project quality control standard).Through the detection of general information, basic health survey,physical examination and blood glucose, blood lipid, using Framingham risk score equation, screening out high-risk ASCVD residents(the next 10 years, the incidence of coronary heart disease risk is greater than or equal to 20%)as the research object, using the circulating enzymatic method for the detection of serum Hcy level, ultrasound examination of carotid artery intima and blood flow, according to whether or not a plaque and severe arterial stenosis, divided into normal group, carotid artery plaque formation and stenosis group, differences in incidence of HHcy and Hcy levels were compared between groups; the study by plasma Hcy divided into normal Hcy group and HHcy group. The research object according to the level of plasma Hcy is divided into normal Hcy group and HHcy group, compared two groups of age composition ratio, the difference of smoking, hypertension,diabetes, body mass index, snoring, high-fat hyperlipidemia, cardiovascular family history factors, using multivariate logistic regression model analysis of hyperhomocysteinemia and cardiovascular and cerebrovascular disease risk factors related.Results1. Base on the census data of Hunan Province Population Census Bureau in 2014, according to the census data, the data of the population in the age and place of residence requirements of the complete survey of 1458 cases. Through the Framingham scoring system, 139 high-risk residents were screened out, among them, 129 were male(92.8%) and 10 were female(7.2%). HHcy group of 89 people(64.1%), the normal group of 50 people(35.9%).2. According to the carotid artery ultrasound results showed that the study object(n=139) carotid normal group of 59 people(42.4%), plaque formation group of 68 people(48.9%), the stenosis group of 12 people(8.7%). The plasma Hcy concentrations in the three groups were 16.89 +7.29 /L mol, 19.13 + 7.04 /L mol, 23.65+ 7.49 /L mol, respectively. The incidence rate of HHcy was 49.1%, 70.6%, 100%, and, respectively. The difference of Hcy concentration and the incidence of HHcy between the three groups were statistically significant(all P<0.05). Compared with the normal group, the concentration of Hcy and HHcy in the plaque formation group were significantly increased(all P<0. 05). Compared with the normal group,the concentration of Hcy and HHcy were significantly increased in the stenosis group(all P<0. 05). Compared with plaque formation, the concentration of Hcy and HHcy were significantly increased in the stenosis group(all P<0.05).3. According to plasma Hcy level, the research object(n=139) HHcy group of 89 people(64.1%), normal group Hcy 50(n=35.9%). Compared with Hcy group, HHcy group, 40-49 years, 50-59 years, 60-69 years old, 70 years old age group composition showed no significant difference(6.7%VS18%, 19.1%VS24%, 42.7%VS28%, 31.5%VS30%, P>0.05);smoking exposure was significantly higher than(86.5%VS64%, P<0.05); the prevalence rate of hypertension increased significantly(80.9%VS52%,P<0.05); diabetes mellitus there was no significant difference(22.5%VS14%,P>0.05); BMI, BMI=24-26, BMI < 24 > 26 BMI group. There were no significant differences(34.8%VS42%, 27%VS28%, 38.2%VS30%, P>0.05);group HHcy snoring is more serious(light 13.5%VS46%, 7.8%VS18%,10%VS51.7%, 27%VS26% P<0.05, heavy weight, high); the prevalence rate of hyperlipidemia was significantly higher(83.1%VS52%, P<0.05); family history of premature cardiovascular disease exposure than the difference was not statistically significant(14.6%VS12%, P> 0.05).4. Whether there will be HHcy as the dependent variables, with age,smoking, hypertension, diabetes, body mass index, snoring, high-fat hyperlipidemia, cardiovascular disease early family history factors as independent variable logistic regression analysis, that age, smoking,hypertension, snoring, high-fat hyperlipidemia and HHcy were significantly related [(OR=1.759, 95%CI1.11-2.787)?(OR=3.680, 95%CI1.309-10.341)?(OR=4.496, 95% CI1.811- 11.158) ?(OR=4.892,95%CI1.905-12.562) ?(OR=1.818,95%CI1.241-2.663),both P<0.05]. And there was no significant correlation between body mass index, diabetes mellitus, cardiac and cerebral vascular disease and HHcy syndrome[(OR=1.547,95%CI0.926-2.586)?(OR=2.254,95%CI0.636-7.994)?(OR=2.024,95%CI0.554-7.369),both P<0.05].Conclusion1. The plasma level of Hcy was increased, and the incidence of HHcy was 64.1%, and HHcy promoted the occurrence and development of carotid atherosclerosis in the rural areas of Changsha.2. Age, smoking, hypertension, snoring, high-fat hyperlipidemia is an important risk factor in the occurrence of Changsha rural ASCVD risk residents HHcy.