医学
同型半胱氨酸
血管疾病
公共卫生
复合维生素的
叶酸
疾病
内科学
重症监护医学
作者
Graeme J. Hankey,John W. Eikelboom
出处
期刊:The Lancet
[Elsevier]
日期:1999-07-31
卷期号:354 (9176): 407-413
被引量:900
标识
DOI:10.1016/s0140-6736(98)11058-9
摘要
For more than 20 years, moderately raised concentrations of total homocysteine (tHcy) have been associated with an increased risk of atherothrombotic vascular events but only recently has evidence mounted to suggest that the association may be causal. The association is independent of other factors, it is fairly consistent across many studies, it is strong and dose-related, and it is biologically plausible. However, the evidence needs to be strengthened by a systematic review of all comparable studies and the demonstration, in randomised trials, that lowering tHcy is followed by a significant reduction in atherothrombotic vascular disease. In addition, the measurement of tHcy needs to be standardised. If these can be achieved then tHcy measurement will become another useful marker of vascular risk, multivitamin therapy will be another therapeutic option for people at risk of atherothrombotic vascular disease, and fortification of food with folic acid will rise high on the political and public health agenda.
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