2020高同型半胱氨酸血症诊疗专家共识PDF.pdf

肿瘤代谢与营养电子杂志2020年9月9 日第7卷第3期　 　 Electron J Metab Nutr Cancer,Sep.9,2020,Vol. 7,No. 3 ·283 · ·共识、指南与标准 · DOI:10.16689/ j.cnki.cn11-9349/ r.2020.03.007 高同型半胱氨酸血症诊疗专家共识 中国营养学会骨健康与营养专业委员会,中华医学会肠外肠内营养学分会,中国老年医学学会北方慢性病防治 分会 摘要: 高同型半胱氨酸血症与多种疾病的发生发展,如心脑血管疾病、高血压、糖尿病、肾脏疾病、妊娠等疾病密切相关, 几乎影响全身的各个器官,通过氧化损伤、DNA 甲基化和含硫化合物代谢异常等多种机制影响细胞的功能、蛋白质的合成与调 控,进而导致组织和器官的病理变化。 总同型半胱氨酸代谢异常的诱因与基因、营养、疾病等关系密切,因此,本专家共识基于 回顾分析近30年的国内外研究文献和循证医学的证据,结合我国人群特点,本专家共识建议将总同型半胱氨酸≥10μmol/ L定 义为高同型半胱氨酸血症;根据同型半胱氨酸相关基因的检测结果和总同型半胱氨酸的水平,通过调整饮食结构和/ 或使用膳 食补充剂包括甜菜碱和B族维生素以及相关辅助因子的营养素补充剂等方法降低总同型半胱氨酸水平,以期显著减缓相关疾 病的发展进程。 推荐开展与同型半胱氨酸相关的检测指标,以明确同型半胱氨酸升高的原因,进而指导临床的精准干预措施, 有效改善同型半胱氨酸水平,实现预防疾病发生或延缓疾病进展的目的。 关键词:高同型半胱氨酸血症;代谢通路;专家共识 Expert consensus on hyperhomocysteinemia BoneHealth and Nutrition Branch of Chinese Nutrition Society, Chinese Society of Parenteral and Enteral Nutrition, North Chronic DiseasePrevention and Treatment Branch of Chinese Geriatric Society Abstract: Highhomocysteinelevels, andavarietyofdiseasedevelopment, suchascardiovasculardisease, hypertension, diabetes, andcloselyrelated diseases such as kidney disease, pregnancy, almost affect the whole body organs, through oxidative damage, DNA methylationandmetabolicabnormalities and other mechanism of sulfur compound affect cell function, protein synthesis and regulation, leadingtothepathological changesof tissuesand organs. Currently, thereisnoguidelinefor the diagnosisand treatment of demographic characteristicsin China. Thisexpert consensus is based on the review and analysis of research literature and evidence-based medicine at homeandabroadinthepast30years, combinedwiththecharacteristicsoftheChinesepopulation, recommendingthattHcy ≥10μmol/ L isdefinedashyperhomocysteinemia. Byadjustingthedietcompositionand/ orusingdietarysupplementssuchasbetaine, vitaminsBand relatedcoenzymenutritional supplements, thelevel of tHcy canbeprominentlyreduced, whichisexpectedto signi