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目的探讨中国农村地区高血压患者不同吸烟状态对叶酸水平的影响及其可能的影响因素。方法2008年5月在连云港及安庆地区进行流行病学调查,通过问卷调查的方式收集高血压患者吸烟状况和其他相关变量,实验室检测血清叶酸、同型半胱氨酸等生化指标。采用多元线性回归模型分析吸烟与叶酸水平之间的关系。结果本研究纳入8 384例男性高血压患者,其中吸烟者4 408例(52.58%)。调整年龄、血压等相关因素后,与从不吸烟者相比,现在吸烟者的叶酸水平降低,差异有统计学意义(β=-0.97,SE=0.09,P<0.01),而曾经吸烟者叶酸水平下降差异无统计学意义(β=-0.16,SE=0.12,P=0.196)。在不同的年龄、体质量指数、同型半胱氨酸水平等分层中,差异有统计学意义。结论吸烟会降低人体内叶酸水平,提倡戒烟以减少吸烟对叶酸带来的生理性损害,而有吸烟接触史的人应补充叶酸,从而提高体内叶酸水平,预防心脑血管事件。
Objective To investigate the effects of different smoking status on folic acid levels and its possible influencing factors in hypertensive patients in rural areas of China. Methods In May 2008, epidemiological investigation was conducted in Lianyungang and Anqing areas. Smoking status and other related variables were collected from patients with hypertension by questionnaire. Serum folic acid and homocysteine were detected in the laboratory. Multivariate linear regression model was used to analyze the relationship between smoking and folic acid levels. Results 8384 men with hypertension were enrolled in this study, of whom 488 were smokers (52.58%). After adjusting for age, blood pressure and other related factors, compared with never smokers, smokers now have reduced levels of folic acid, the difference was statistically significant (β = -0.97, SE = 0.09, P <0.01) There was no significant difference between the two groups (β = -0.16, SE = 0.12, P = 0.196). In different age, body mass index, homocysteine level stratification, the difference was statistically significant. Conclusion Smoking reduces the level of folic acid in the human body, and promotes smoking cessation to reduce physiological damage caused by folic acid. However, people with smoking history should be supplemented with folic acid so as to increase folate levels in the body and prevent cardiovascular and cerebrovascular events.