ABSTRACT
Homocysteine is a sulphur-containing amino acid formed in the metabolism of methionine, which is not a normal part of the diet. Increased plasma total homocysteine concentrations is an independent risk factor for coronary artery disease, peripheral vascular disease, and stroke. The putative mechanism whereby high homocysteine levels lead to vascular disease may be related to diabetes and its complications. The aim of this study was to evaluate the plasma level of homocysteine in diabetic patients with and without microvascular complications. Subjects and Sixty diabetic patients and thirty healthy control subjects were included in this work. The diabetic patients were divided into 2 groups: group I included thirty patients with microvascular complications and group II included thirty patients without microvascular complications. Each diabetic patient and control subject was subjected to the following: thorough history taking, complete clinical examination, ophthalmoscopic examination and tests for somatic and autonomic functions. Laboratory investigations including: glycaemic control parameters [fasting and 2 hours postprandial plasma glucose, glycosylated haemoglobin], lipid profile parameters [serum total cholesterol, triglycerides, LDL-C and HDL-C] and plasma concentrations of homocysteine, folic acid as well as vitamin B12. Testing for urinary albumin excretion was done by ELISA. The plasma level of homocysteine was significantly higher in diabetic patients with microvascular complications than those without and still higher than controls [P < 0.05]. Also, the homocysteine level was significantly and positively correlated with duration of diabetes, fasting plasma glucose, glycosylated haemoglobin, serum triglycerides, urinary albumin excretion, proliferative retinopathy and somatic neuropathy [P< 0.05], while there was a significant negative correlation between homocysteine level and plasma folic acid and vitamin B12 [P< 0.05]. Conclusions: Our results suggest that the fasting level of homocysteine is increased in diabetic patients and such level is influenced by the duration of diabetes, metabolic control and the microvascular diseases. So, these findings may add to the understanding of the increased frequency and mechanisms of vascular damage in diabetes and provide new link between hyperhomocysteinemia and the pathophysiology of microvascular complications in diabetes