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中国循证儿科杂志

中国循证儿科杂志 ›› 2025, Vol. 20 ›› Issue (1): 44-47.DOI: 10.3969/j.issn.1673-5501.2025.01.007

• 论著 • 上一篇    下一篇

备孕家庭男方同型半胱氨酸水平及影响因素的横断面调查

王定美1,张弈1,陈逍天1,李梦茹1,姚沁玙1,彭远舟1,顾晓妍1,马晓静1,2,严卫丽1,2,黄国英1,2   

  1. 1 复旦大学附属儿科医院 上海，201102； 2 上海市出生缺陷防治重点实验室 上海，201102


  • 收稿日期:2025-01-03 修回日期:2025-01-09 出版日期:2025-02-25 发布日期:2025-02-25
  • 通讯作者: 黄国英;严卫丽

Male homocysteine level and its influencing factors in families preparing for pregnancy： A cross-sectional survey

WANG Dingmei1, ZHANG Yi1, CHEN Xiaotian1, LI Mengru1, YAO Qinyu1，PENG Yuanzhou1, GU Xiaoyan1, MA Xiaojing1,2, YAN Weili1,2, HUANG Guoying1,2   

  1. 1 Children’s Hospital of Fudan University, Shanghai China,201102; 2 Shanghai Key Laboratory of Birth Defect, Shanghai 201102, China
  • Received:2025-01-03 Revised:2025-01-09 Online:2025-02-25 Published:2025-02-25
  • Contact: HUANG Guoying; YAN Weili

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摘要： 背景：全人群的高血清同型半胱氨酸（Hcy）的发生率高达37.2％，备孕家庭男方的Hcy水平及高Hcy的发生率尚不清楚。 目的：调查备孕家庭男方Hcy的现况并分析其影响因素。 设计：横断面调查。 方法：：以2016 年 3 月至2022 年 1 月上海市亲子出生队列（SPCC）中上海市9区16家孕前检查的综合型医院或区妇幼保健院（所）备孕家庭中的男方为调查对象，通过问卷调查采集社会人口学信息、近3个月叶酸补充剂使用、吸烟和饮酒情况，同时收集血清样本检测Hcy（≥15 μmol·L-1 为高Hcy）。 主要结局指标：影响备孕家庭男方Hcy的影响因素。 结果：进入本文分析16 242名备孕家庭男方，年龄21.4~67.0（30.5±4.5）岁，<30岁占51.8%，BMI≥24 kg·m-2占47.1%，本科及以下学历占83.5%，家庭收入<20万占56.2%，叶酸补充剂使用率6.6%。Hcy平均水平10.9（95%CI：8.9~13.9）μmol·L-1， 高Hcy占20.5%； 多因素Logistic分析结果：显示，备孕男方补充叶酸（OR=0.48, 95%CI:0.38~0.60）、年龄增加（OR=0.82, 95%CI：0.74~0.91）、家庭年收入越高（OR=0.86, 95%CI:0.77~0.96）、居住地为传统市区（OR=0.84, 95%CI:0.73~0.96），其高Hcy风险越低，吸烟（OR=1.20, 95%CI:1.09~1.33）可增加高Hcy风险。 结论：备孕男方的Hcy水平偏高，5个备孕男方中有1个患有高Hcy，需加大降低Hcy的健康宣教，如避免吸烟、使用叶酸补充剂等可能降低备孕男方Hcy水平。

关键词: 备孕男方, 同型半胱氨酸, 高同型半胱氨酸血症, 队列研究

Abstract: Background：The incidence of high serum homocysteine (HHcy) was 37.2% in the whole population. The level of male Hcy and the incidence of male HHcy in families preparing for pregnancy are unknown. Objective：To investigate the status of male Hcy in families preparing for pregnancy and analyze its influencing factors. Design：A cross-sectional survey. Methods：In the Shanghai Parent Child Birth Cohort (SPCC) from March 2016 to January 2022, men were recruited from 16 general hospitals or district maternal and child health hospitals or institutes in 9 districts of Shanghai for pre-pregnancy examination. Socio-demographic information, folic acid supplement use, smoking and alcohol consumption in the past 3 months were collected through questionnaires, and blood samples were collected to detect Hcy (≥15 μmol·LL-1 as HHcy). Main outcome measures：Indicators influencing male Hcy in families preparing for pregnancy. Results：A total of 16,242 men from preconception families were included in this analysis. Their ages ranged from 21.4 to 67.0 years, with a mean age of 30.5±4.5 years. Among them, 51.8% were younger than 30 years old, 47.1% had a body mass index (BMI) of ≥24 kg-2, 83.5% had an education level of a bachelor's degree or lower, and 56.2% had an annual household income of less than 200,000 RMB. The usage rate of folic acid supplements was 6.6%. The mean homocysteine (Hcy) level was 10.9 μmol·L-1 (95% CI: 8.9-13.9), with 20.5% of participants classified as having high Hcy (≥15 μmol·L-1). Multivariate logistic regression analysis revealed that folic acid supplementation (OR=0.48, 95% CI: 0.38-0.60), older age (OR=0.82, 95% CI: 0.74-0.91), higher household income (OR=0.86, 95% CI: 0.77-0.96), and residence in a traditional urban area (OR=0.84, 95% CI: 0.73-0.96) were protective factors associated with a lower risk of high Hcy levels. Conversely, smoking (OR=1.20, 95% CI: 1.09-1.33) was found to increase the risk of high Hcy levels. Conclusion：Hcy levels in men preparing for pregnancy are relatively high, with one in five men experiencing HHcy. Health education should focus on promoting behaviors that lower Hcy levels, such as smoking cessation and folic acid supplementation.

Key words: Men preparing for pregnancy, Homocysteine, Hyperhomocysteinemia, Cohort study