Homocysteine in diabetic patients with and without macrovascular complications

ABSTRACT

Small and large vessel disease is characteristic of the diabetic state. The excess mortality of the patients with type 1 and type 2 diabetes is mainly due to cardiovascular disease and is not adequately explained by conventional cardiovascular risk factors. Homocysteine [Hcy] is a sulphur-containing amino acid formed during the metabolism of dietary methionine. Adequate concentrations of folic acid, vitamins B12 and B6 are essential for the metabolism and dispersal of Hcy. Recently, mild elevations of plasma Hcy have been identified as an independent risk factor for early atherosclerotic vascular disease. The aim of this work was to measure the plasma level of Hcy in diabetic patients with and without macrovascular complications. Subjects and We studied 60 diabetic patients [30 with macrovascular complications and 30 without macrovascular complications] together with 30 healthy subjects as controls. For each patient and control we did history taking, clinical examination and laboratory investigations including glycemic parameters, lipid profile, Hcy, folic acid, vitamin B12 measurement and evaluation for macrovascular complications. We found that Hcy level was significantly higher in diabetic with macrovascular complications than those without and than controls. Also, Hcy level was positively correlated with the number of complications and lipid profile, but negatively correlated with vitamin B12 and folic acid concentration [P<0.005]. Conclusions: Homocysteine is an important risk factor for macrovascular complications of diabetes