Role of plasma homocysteine concentration in type-1-diabetes with and without nephropathy

ABSTRACT

To determine the plasma level of total homocysteine [tHcy] as a marker of endothelial cell dysfunction and to investigate its possible role in type I diabetes [IDDM] with nephropathy. A randomized group comparative and cross sectional study. A total of 60 type I diabetic patients, 40 of them were complicated with nephropathy.20 patients without complication [s] and 20 healthy control subjects matched for sex and age. Suez Canal University Hospital. Fasting plasma concentration of tHcy was estimated by immunoenzymatic assay, hemoglobin was measured by affinity chromatographic method. Albumin excretion rate was determined by immunturbidometric method. Fasting blood glucose was determined by glucose oxidase method and serum creatinine was measured by alkaline picrate method. Type 1[IDDM] patients with nephropathy showed a significant increase of the fasting plasma tHcy levels compared to controls and those patients without complications. A significant positive correlation was observed between fasting tHcy and albumin excretion rate [AER] in patients with diabetic nephropathy. Also tHcy had positive significant correlation with serum creatinine and HbAlc. Meanwhile there was no significant correlation between tHcy and the following parameters, age, duration of diabetes and body mass index [BMI]. tHcy was increased in type I diabetic patients with nephropathy, tHcy was significantly correlated to AER, serum creatinine and HbAlc in type I diabetic patients with nephropathy tHcy contribute to enhanced rate of vascular complications observed in type I diabetic patients, tHcy can be an important risk factor that worsen prognosis