Relationship between plasma homocysteine level and some cardiovascular risk factors in patients with type 2 diabetes

ABSTRACT

High plasma homocysteine [Hcy] concentration is risk factor for cardiovascular disease. Insulin resistance has been hypothesized to play an important role in the development of atherosclerotic disease. The information on the association between insulin resistance, other cardiovascular risk factors and plasma Hcy in type 2 diabetes is limited. The aim of our study was to assess the impact of insulin resistance and other cardiovascular risk factors on plasma total Hcy levels in patients with type 2 diabetes. The study included 40 patients with type 2 diabetes [aged 42.0 +/- 4.1 years] and 15 healthy controls, matched in age and sex with the patients. The following parameters were assessed fasting plasma glucose [FPG], fasting plasma insulin [FPI], homeostasis model assessment of insulin resistance [HOMA-IR], serum total cholesterol, triglycerides, HDL-C, LDL-C and plasma total Hcy. Our study revealed significant increase in SBP, FPG, FPI, HOMA-IR, and total Hcy in type 2 diabetic patients compared to control group [137 +/- 4 vs 123 +/- 5 mmHg, 103 +/- 10.1 vs 83.2 +/- 6.9 mg/dl; 20.1 +/- 4.1 vs 8.8 +/- 3.1 mu/L, 5.8 +/- 0.8 vs 1.93 +/- 0.26, 13.6 +/- 1.2 vs 7.6 +/- 0.8 umol/L, respectively, all P<0.001]. As regard serum lipids our results revealed significant increase in total cholesterol, triglycerides and LDL-C but significant decrease in HDL-C in type 2 diabetic patients compared to control group [210 +/- 39 vs 160 +/- 21 mg/dl, 220 +/- 29 vs 106 +/- 10 mg/dl, 129 +/- 28 vs 88 +/- 21 mg/dl, 40 +/- 11 vs 52 +/- 16 mg/dl, respectively, all P<0.05]. In patients with type 2 diabetes there was significant positive correlation between total Hcy and SBP, FPG, FPI, HOMA-IR, total cholesterol and LDL-C [r = 327, P = 0.005, r = 240, P = 0.049, r = 0.513, P<0.001; r = 0.601, P<0.001, r = 0.241, P = 0.048; r = 0.250, P = 0.040 respectively], but there was significant negative correlation between total Hcy and HDL-C [r = -0.301, P = 0.009]. Increases in total homocysteine levels in type 2 diabetes are associated with insulin resistance and other cardiovascular riskfactors. Thus insulin resistance may be an important determinant of Hcy levels in those patients