叶酸 同型半胱氨酸及其代谢过程关键酶mthfr c677t mtr a2756g基因多态性与中国高血压人群肝 肾功能关系研究-study on the relationship between folic acid homocysteine and mth fr c677t mtr 2756 g gene polymorphism and liver and kidney function in chinese hypertensive p.docxVIP

2材料与方法................................................302.1研究人群...............................................362.2血样本收集和实验室检测.................................362.3知情同意...............................................362.4体格测量...............................................362.5问卷调查...............................................362.6相关定义...............................................362.7统计分析...............................................373结果......................................................373.1研究人群的基线特征.....................................373.2血清同型半胱氨酸和MTHFR基因C677T多态性与eGFR和血清肌酐的相关性403.3血清同型半胱氨酸和eGFR下降风险的关系423.4MTHFR基因C677T、MTR基因A2756G多态性对血浆同型半胱氨酸和eGFR关联的交互作用424讨论......................................................44参考文献....................................................49论文小结....................................................54附录........................................................54致谢........................................................56综述........................................................58主要缩略词中英文对照ALTalanineaminotransferase谷丙转氨酶BMIbodymassindex体质指数CKDchronickidneydisease慢性肾脏病CVDCardiaovasculardisease心血管疾病DBPdiastolicbloodpressure舒张压ESRDendstagerenaldisease终末期肾脏疾病eGFRestimatedglomerularfiltrationrate肾小球滤过率FPGfastingplasmaglucose空腹血浆葡萄糖γ-GGTHDLHcyMTRMTHFRScrSBPTCTGgamma-glutamyltransferasehighdensitylipoproteinhomocysteineMethioninesynthasemethylenetetrahydrofolatereductaseserumcreatininesystolicbloodpressuretotalcholesteroltriglycerideγ-谷氨酰转肽酶高密度脂蛋白同型半胱氨酸蛋氨酸合成酶亚甲基四氢叶酸还原酶血清肌酐收缩压总胆固醇三酰甘油叶酸、同型半胱氨酸及其代谢过程关键酶（MTHFRC677T、MTRA2756G）基因多态性与中国高血压人群肝、肾功能关系研究摘要目的：考察叶酸、同型半胱氨酸水平及其代谢过程关键酶（MTHFRC677T和MTRA2756G）基因多态性与中国轻中度高血压人群肝、肾功能的关系。方法：本研究在哈尔滨、沈阳、北京、西安、南京和上海六个地区入选了480名轻中度原发性高血压患者，采用标准问卷和操作规程采集患者相关信息。结果：研究一：Hcy水平与eGFR的水平呈显著负相关（P0.001），与血清肌酐水平呈显著正相关（P0.001），而MTHFR基因C677T和MTR基因A2756G多态性与eGFR或者血清肌酐均无显著关联。将eGFR90ml/min/1.73m2定义为eGFR下降，多元Logistic回归分析显示，在男性患者中，Hcy升高(≥10μmol/Lversus10μmol/L)和重度升高（≥15μmol/Lversus10μmol/L）发生eGFR下降的风险分别为：1.23(95%CI:1.02-1.47)和1.27（95%C