관상동맥협착 환자의 혈장 총 Homocysteine, 엽산 및 비타민 B12 농도 (Plasma total homocysteine, folate and vitamin B12 concentrations in patients with coronary stenosis)

서지정보

· 발행기관 : 대한지역사회영양학회
· 수록지 정보 : 대한지역사회영양학회지 / 10권 / 6호 / 963 ~ 970페이지
· 저자명 : 임현숙, 허영란

초록

Homocysteine이 허혈성심질환을 포함한 동맥경화증 및혈전증의 독립된 위험 인자로 알려져 있으며 이는 점차 국내에서도 연구가 활발한 분야이다. 이에 본 연구에서는 한국인 관상동맥질환자를 관동맥조영술상 1 개 이상의 혈관에서 50% 이상의 협착이 있는 환자 26명과, 흉통을 주소로 하나 관동맥조영술상 유의한 협착이 없는 30명의 환자를 대조군으로 하여, 혈중 총 homocysteine, folate 및vitamin B12의 농도를 각각 측정하여 이들의 상관관계를분석하였다.
혈중 총 homocysteine의 농도는 환자군에서 대조군에비해 상승된 소견 보이고 있었으며 10.7 ± 4.2 vs 9.6 ± 3.5 μmol/L). 혈중 folate 및 vitamin B12의 농도는 환자군에서 대조군에 비해 낮은 경향이었다. 환자군에서 혈중총 homocysteine의 농도는 folate, vitamin B12 농도와음의 상관관계(folate; r = -0.550, p < 0.01 : vitamin B12; r = -0.609, p < 0.01)가 있었다. 이에 한국인의 경우에도folate 또는 vitamin B12의 보충을 통한 이들 비타민의 혈장 농도 개선이 homocysteine 농도를 낮춤으로써 관상동 맥질환의 이환율과 사망율을 낮추는데 기여할 수 있을 것으로 기대된다.

영어초록

Recently elevated plasma homocysteine concentration is considered an independent risk factor for atherosclerosis and thrombosis with coronary artery disease. Folate and vitamin B12 are cofactors and closely related with metabolism of homocysteine. The purpose of this study is to evaluate the correlation between homocysteine and folate and vitamin B12 in patients with ischemic heart disease. Twenty-six patients, in whom coronary angiographic finding revealed more than 50% of stenosis at least in one coronary vessel were enrolled as the patient group, and thirty subjects, in whom angiographic finding revealed in not significant stenosis, but complained of chest pain, were selected as the control group. Fasting venous blood was obtained and measured the concentration of plasma total homocysteine, folate and vitamin B12 by high performance liquid chromatography and fluorescence detection method. We examined the correlation between homocysteine and folate and/or vitamin B12 in the control group and the patient group, respectively. Compared with the control group, the patient group had relatively higher plasma total homocysteine concentration (10.7 ± 4.2 vs 9.6 ± 3.5 umol/L), but showed no significant difference. Folate and vitamin B12 concentration are low in the patient group, but showed no significant difference between patient and control group. Plasma total homocysteine concentration showed negative correlation with folate and vitamin B12 in both the control group and the patient group, and showed significantly negative correlation in patient group {r = -0.550 (p < 0.01) vs r = -0.609 (p < 0.01)}. We knew that the plasma total homocysteine concentration were relatively elevated in patient group compared with the control group. Because plasma total homocysteine concentrations are closely negative correlated with folate and vitamin B12 in the patient group, folate and vitamin B12 supplement can lower the mortality and morbidity of ischemic heart disease. (Korean J Community Nutrition 10(6): 963 ~ 970, 2005)

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