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Journal of the Korean Academy of Family Medicine 2006;27(1):12-20.
Published online January 10, 2006.
Hyperhomocysteinemia and Cerebrovascular Diseases in Koreans.
Bu Kyoung Yoon, Chul Gab Lee, Rae Sang Kim, Man Jin Cha
1Department of Family Medicine, Jeongeup Asan Hospital, Jeongeup, Korea.
2Department of Neurosurgery, Jeongeup Asan Hospital, Jeongeup, Korea.
3Department of Occupational & Environmental Medicine, Chosun University Hospital, Gwangju, Korea. eecg@paran.com
한국인에서 고호모시스테인혈증과 뇌혈관질환
: Hyperhomocysteinemia as a risk factor for cerebrovascular disease is well known. Our aim of this study was to demonstrate positive association between elevated homocysteine levels and cerebrovascular diseases in Koreans.

Methods : With a case-control design, 186 stroke (infarction 134, hemorrhage 52) patients, diagnosed by brain CT or MRI and 359 control patients were evaluated. We used multiple logistic regression analyses conditioned on the matching variables (sex, age, hypertension, DM, smoking, hyperlipidemia, hyperhomocysteinemia) and calculated odds ratio and 95% CIs.

Results : Multivariate adjusted odds ratios (OR) for cerebrovascular diseases associated with hypertension compared with normal blood pressure were 2.45 (95% CI, 1.16 to 5.15) in prehypertension and 3.33 (95% CI, 1.56 to 7.10) in stage 1 hypertension and 3.77 (95% CI, 1.32 to 10.74) in stage 2 hypertension. OR for cerebrovascular diseases associated with hyperhomocysteinemia compared with <10μmol/L were 2.06 (95% CI, 1.09 to 3.91) in 13.0 to 16.9μmol/L and 3.17 (95% CI, 1.70 to 5.90) in ≥17μmol/L.

Conclusion : Not only hypertension but also hyperhomocysteinemia was a significant risk factor for cerebrovascular diseases in Koreans.
Key Words: homocysteine, cerebrovascular disease, case- control study, odds ratio, Koreans
연구배경 : 뇌혈관질환의 위험인자로 알려진 고호모시스테인혈증이 한국인에서도 위험요인으로 작용하는지 알아보고자 하였다.

방법 : 뇌혈관질환자 186명(뇌경색 134명, 뇌출혈 52명)과 대조군 359명의 환자대조군 연구로, 뇌혈관질환의 위험인자로 알려진 성, 나이, 고혈압, 당뇨, 흡연, 고지혈증, 고호모시스테인혈증의 다변량 로지스틱회귀분석으로 대응비를 구하였다.

결과 : 뇌혈관질환 발생 대응비는 정상혈압에 비해 초기 고혈압은 2.45배(95% 신뢰구간 1.16~5.15), 1단계 고혈압은 3.33배(95% 신뢰구간 0.92~2.24), 2단계 고혈압은 3.77배(95% 신뢰구간 1.32~10.74)이었으며, 호모시스테인 농도가 10μmol/L에 비해 13.0~16.9μmol/L인 경우는 2.73배(95% 신뢰구간 1.09~3.91), 17.0μmol/L 이상인 경우는 3.17배(1.70~ 5.90) 높았다.

결론 : 고호모시스테인혈증은 고혈압과 함께 한국인에서 뇌혈관질환 발생의 위험요인으로 추정된다
중심 단어: 호모시스테인, 뇌혈관질환, 환자-대조군 연구, 대응비, 한국인


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