Correlation between Helicobacter pylori infection and homocysteine levels and cerebral small vessel disease

中华行为医学与脑科学杂志 Pub Date : 2020-01-20 DOI:10.3760/CMA.J.CN371468-20190417-00261

N. Zhao, Zhu Chen, Peng Wang, Fang Li

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引用次数: 0

Abstract

Objective To study the relationship between Helicobacter pylori (HP) infection and homocysteine (Hcy) levels and cerebral small vessel disease (CSVD). Methods From March 2017 to December 2018, 67 patients (outpatient and inpatient) who complained of dizziness in the First Affiliated Hospital of Jinzhou Medical University were divided into CSVD group(30 cases) and control group(37 cases). Single factor analysis, Spearman correlation analysis and binary logistic regression analysis were used to analyze the influencing factors of CSVD.Receiver operating characteristic curve was used to predict the diagnostic value of influencing factors for CSVD.The effects of HP and Hcy on CSVD were analyzed using mediation effect. Results (1)Hcy (r=0.345, P=0.004), HP positive (r=0.274, P=0.026), age (r=0.420, P=0.000), male (r=0.260, P=0.034), total cholesterol (r=0.273, P=0.025), triglycerides (r=0.272, P=0.026), hypertension (r=0.454, P=0.000), diabetes (r=0.284, P=0.020), smoking (r=0.499, P=0.000), coronary heart disease (r=0.284, P=0.020) were positively correlated with CSVD.(2)Logistic regression analysis showed that Hcy (β=0.315, OR=1.370, 95%CI=1.025-1.831), total cholesterol (β=0.979, OR=2.661, 95%CI=1.086-6.523) were independent risk factors for CSVD.(3)Hcy (sensitivity: 76.7%, specificity: 86.5%)and total cholesterol levels(sensitivity: 90.0%, specificity: 83.8%) had specific and sensitive diagnostic value for the diagnosis of CSVD, and total cholesterol (area under ROC curve=0.928) had more diagnostic value than Hcy (area under ROC curve=0.877). (4) The mediating effect of HP on CSVD was not completely affected by the mediating effect of Hcy, and HP had partially direct effect on CSVD. Conclusions (1) Hcy and total cholesterol are independent risk factors of CSVD, which have specific and sensitive diagnostic value for CSVD, especially for total cholesterol.(2)The mediating effect of HP on CSVD is not completely affected by the mediating variable Hcy, and HP has a partially direct effect on CSVD. Key words: Cerebral small vessel disease; Risk factors; Homocysteine; Helicobacter pylori

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幽门螺杆菌感染与同型半胱氨酸水平与脑血管病的关系

目的探讨幽门螺杆菌（HP）感染、同型半胱氨酸（Hcy）水平与脑小血管病（CSVD）的关系。方法2017年3月至2018年12月，将锦州医科大学附属第一医院67例主诉头晕的门诊和住院患者分为CSVD组（30例）和对照组（37例）。采用单因素分析、Spearman相关分析和二元logistic回归分析对CSVD的影响因素进行分析，采用受试者操作特征曲线预测影响因素对CSVD诊断价值，采用中介效应分析HP和Hcy对CSVD影响。结果（1）Hcy（r=0.345，P=0.004）、HP阳性（r=0.274，P=0.026）、年龄（r=0.420，P=0.000）、男性（r=0.260，P=0.034）、总胆固醇（r=0.273，P=0.025）、甘油三酯（r=0.272，P=0.026。（2） Logistic回归分析显示，Hcy（β=0.315，OR=1.370，95%CI=1.025-1.831）、总胆固醇（β=0.979，OR=2.661，95%CI=1.08-6.523）是CSVD的独立危险因素。（3） Hcy（敏感性76.7%、特异性86.5%）和总胆固醇水平（敏感性90.0%、特异性83.8%）对CSVD的诊断具有特异性和敏感性，总胆固醇（ROC曲线下面积=0.928）比Hcy（ROC线下面积=0.877）更有诊断价值。（4）HP对CSVD的介导作用不完全受Hcy介导作用的影响，HP对CSVD有部分直接作用。结论（1）Hcy和总胆固醇是CSVD的独立危险因素，对CSVD，尤其是总胆固醇具有特异、灵敏的诊断价值。（2） HP对CSVD的介导作用不完全受介导变量Hcy的影响，HP对CSVD有部分直接影响。关键词：脑小血管病；风险因素；同型半胱氨酸；幽门螺杆菌

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来源期刊

中华行为医学与脑科学杂志

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8131

期刊介绍： "Chinese Journal of Behavioral Medicine and Brain Science" (CN 37-1468/R, ISSN 1674-6554) is a national academic journal under the supervision of the National Health Commission, sponsored by the Chinese Medical Association and Jining Medical College. The journal was founded in June 1992 and was formerly known as "Chinese Journal of Behavioral Medicine" (1992-1993) and "Chinese Behavioral Medical Science" (1994-2008). In 2009, it was renamed "Chinese Journal of Behavioral Medicine and Brain Science" with the approval of the State Administration of Press, Publication, Radio, Film and Television. The purpose of "Chinese Journal of Behavioral Medicine and Brain Science" is to implement the health and health policies of the Party and the State, implement the principle of combining theory with practice and popularization and improvement, and reflect the major progress in the theory and practical application of behavioral medicine and brain science in my country. It publishes academic papers and scientific research results in the field of behavioral medicine and brain science in my country, and has columns such as monographs/reviews, basic research, clinical research, health prevention, methods and techniques, psychological behavior and evaluation, and systematic evaluation.