The relation between plasma homocysteine level and amyotrophic lateral sclerosis

目的 探讨血浆同型半胱氨酸(Hcy)水平与肌萎缩侧索硬化症(ALS)间的关系.方法 分别检测150例确诊或拟诊的ALS患者和137例年龄、性别匹配的健康体检者的血叶酸,维生素B12和Hcy水平,比较两组间的差异.结果 ALS患者血Hcy水平较对照组明显增高[(18.47±13.09)μmol/L比(11.91±5.37) μmol/L,P＜0.001],而血叶酸水平显著降低[(8.39±4.45) μg/L比( 10.38 5.01) μg/L,P＜0.001].logistic回归显示血Hcy水平与ALS相关,是重要的危险因素；同样发现诊断间期( Interval from symptom onset to diagnosis,ODI)少于19个月的患者较超过19个月的患者血浆Hcy水平明显增高[(20.73 15.79) μmol/L比(16.41±9.73) μmol/L,P=0.035].结论 ALS患者血浆Hcy水平较健康对照明显增高,血Hcy水平和诊断间期相关预示血浆Hcy水平可能与病程进展速度有关.Objective To investigate the relationship between plasma level of homocysteine (Hcy) and amyotrophic lateral sclerosis (ALS).Methods The differences of Hcy,Vitamin B12,and folate levels between 150 outpatients with ALS and 137 age and sex matched controls were compared in a cross-sectional study.Results Compared with the healthy controls,patients with ALS had a higher plasma Hcy level [ ( 18.47 ± 13.09) μmol/L vs ( 11.91 ± 5.37 ) μmol/L,P ＜ 0.001 ] and a lower folate level [ ( 8.39 ±4.45) ng/ml vs (10.38 ±5.01) ng/ml,P ＜0.001].In a logistic regression model using ALS as a dependent variable,plasma level of Hcy was significantly associated with ALS.A trend for higher Hcy levels in patients with shorter interval from symptom onset to diagnosis ( ODI ) was also found [ Hcy levels (20.73 ± 15.79 ) μmol/L with ODI ＜ 19 months vs ( 16.41 ± 9.73 ) μmol/L with ODI ≥ 19 months,P =0.035 ].Conclusions Plasma Hcy level is significantly increased in patients with ALS.The individuals with shorter time to diagnosis present higher Hcy level,suggesting that it may associate with the progression pace of ALS.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)04308-3105