cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-2105Research ArticleИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦАCORONARY HEART DISEASEФакторы, определяющие уровень гомоцистеина, в когорте российских пациентов со стабильной ишемической болезнью сердцаFactors determining homocysteine levels in Russian patients with stable coronary heart diseaseШахматоваО. О.ShakhmatovaO. O.

аспирант

olga.shahmatova@gmail.comКомаровА. Л.KomarovA. L.

ст.н.с.

РебриковД. В.RebrikovD. V.

директор по науке, директор центра коллективного пользования отделения биологических наук

ТурчаниноваМ. А.TurchaninovaM. A.

н.с.

КоткинаТ. И.KotkinaT. I.

врач высшей категории, руководитель клинико-диагностической лаборатории

БолвачеваА. В.BolvachevaA. V.

врач высшей категории

ДеевА. Д.DeevA. D.

рук. лаборатории биостатистики

ДобровольскийА. Б.DobrovolskyA. B.

вед.н.с.

ТитаеваЕ. В.TitaevaE. V.

ст.н.с.

ПанченкоЕ. П.PanchenkoE. A.

руководитель лаборатории клинических проблем атеротромбоза

ФГУ Российский кардиологический научно-производственный комплекс РосмедтехнологийRussian Cardiology Scientific and Clinical ComplexЗАО “Научно-производственная фирма ДНК-Технология”; Институт общей генетики им. Н. И. Вавилова РАНDNA-Technology Company; N.I. Vavilov Institute of General Genetics; Russian Academy of SciencesЗАО “Научно-производственная фирма ДНК-Технология”DNA-Technology CompanyФГУ Государственный научно-исследовательский центр профилактической медицины Росмедтехнологий. МоскваState Research Centre f or Preventive Medicine. Moscow201020082010944958Copyright © Шахматова О.О., Комаров А.Л., Ребриков Д.В., Турчанинова М.А., Коткина Т.И., Болвачева А.В., Деев А.Д., Добровольский А.Б., Титаева Е.В., Панченко Е.П., 20102010Шахматова О.О., Комаров А.Л., Ребриков Д.В., Турчанинова М.А., Коткина Т.И., Болвачева А.В., Деев А.Д., Добровольский А.Б., Титаева Е.В., Панченко Е.П.Shakhmatova O.O., Komarov A.L., Rebrikov D.V., Turchaninova M.A., Kotkina T.I., Bolvacheva A.V., Deev A.D., Dobrovolsky A.B., Titaeva E.V., Panchenko E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2105

Цель. Определить факторы, влияющие на уровень гомоцистеина (ГМЦ) в российской популяции пациентов со стабильной ишемической болезнью сердца (ИБС). Материал и методы. В исследование включены 506 пациентов (388 мужчин, средний возраст 59,4±12,2 лет) со стабильной ИБС. Были оценены классические факторы риска (ФР) сердечно-сосудистых заболеваний (ССЗ), почечная функция (клиренс креатинина по формуле Кокрофта-Гаулта), а также степень атеросклеротического поражения в других сосудистых бассейнах. Были определены уровни ГМЦ, фолата и кобаламина плазмы. Генетический анализ осуществляли методом полимеразной цепной реакции в реальном времени. Результаты. У 432 пациентов (85,4 %) была диагностирована гипергомоцистеинемия. Средний уровень ГМЦ составил 14,3±4,6 мкмоль/л. По данным многофакторного анализа с использованием вложенных моделей, тремя факторами, независимо влияющими на уровень ГМЦ, оказались: уровень фолата (бетакоэффициент -3,86, p<0,0001), уровень кобаламина (бета -5,73, p<0,0001) и генотип MTRR 66AA (бета 10,71, p<0,0005). На уровень ГМЦ влияли такие комбинированные состояния, как аллель MTRR 66G + уровень фолата (бета 1,12, p<0,0001), аллель MTRR 66AA + уровень кобаламина (бета 0,012, p<0,0001), аллель TCN 776G + уровень кобаламина (бета -0,03, p<0,0001), аллель TCN 776G + уровень фолата (бета 0,58, p<0,0009), аллель MTR 2756G + уровень кобаламина (бета 0,004, p<0,002), аллель MTRR 66G + клиренс креатинина <90 мл/мин (бета 0,08, p<0,001) и аллель TCN 776G + клиренс креатинина <90 мл/ мин (бета 0,07, p<0,0007). Заключение. У российских пациентов со стабильной ИБС на уровень ГМЦ влияют уровни фолата, кобаламина, генотип MTRR 66AA, а также носительство аллелей MTR 2756G, MTRR 66G, TCN 776G с учетом концентрации витаминов и функции почек.

Aim. To identify the factors determining homocysteine (HMC) levels in Russian patients with stable coronary heart disease (CHD). Material and methods. The study included 506 patients (388 men; mean age 59,4±12,2 years) with stable CHD. Classical risk factors (RFs) of cardiovascular disease (CVD), renal function (creatinine clearance by Cockroft-Gault formula), and atherosclerotic pathology of other localizations were assessed. The levels of plasma HMC, folate, and cobalamin were measured. Genetic analysis was performed using the real-time polymerase chain reaction method. Results. In 432 patients (85,4 %), hyperhomocysteinemia was diagnosed. The mean HMC level was 14,3±4,6 mkmol/l. According to multifactor analysis results, HMC level was independently associated with folate level (beta coefficient -3,86, p<0,0001), cobalamin level (beta -5,73, p<0,0001), and MTRR 66AA genotype (beta 10,71, p<0,0005). In addition, HMC concentration was linked to the following combinations: MTRR 66G allele + folate level (beta 1,12, p<0,0001), MTRR 66AA allele + cobalamin level (beta 0,012, p<0,0001), TCN 776G allele + cobalamin level (beta -0,03, p<0,0001), TCN 776G allele + folate level (beta 0,58, p<0,0009), MTR 2756G allele + cobalamin level (beta 0,004, p<0,002), MTRR 66G allele + creatinine clearance <90 ml/min (beta 0,08, p<0,001), and TCN 776G allele + creatinine clearance <90 ml/min (beta 0,07, p<0,0007). Conclusion. In Russian patients with stable CHD, HMC level was associated with folate and cobalamin concentrations and MTRR 66AA genotype, as well as with MTR 2756G, MTRR 66G, and TCN 776G alleles combined with vitamin concentrations and renal function.

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The authors declare that there are no conflicts of interest present.