RESUMO
BACKGROUND/AIM: The evaluation of the significance of hyperhomocysteinemia in type 2 diabetes is further complicated by the multiple ways of considering impaired renal function, vitamin status, and lifestyle. The aim of our study was to investigate the relation between macro- and micronutrient intakes and homocysteine levels in a population having diabetes type 2. METHODS: A total of 155 patients with diabetes mellitus type 2 attending our Diabetes Service (90 females and 65 males) were enrolled in a consecutive way. All patients underwent determination of fasting blood homocysteine, glycated hemoglobin, glucose, vitamin B(12), and folate levels. Microalbuminuria was evaluated on the basis of a 24-hour urine. The patients were instructed to keep 3-day written food records incorporating the use of food scales and models to enhance portion size accuracy. Alcohol drinking, physical activity, and smoking habits were also registered. RESULTS: The mean homocysteine levels were 10.5 +/- 4.3 micromol/l. The mean glucose and Hb A(Ic) levels were 9.5 +/- 3 mmol/l and 7.8 +/- 1.4%, respectively. The vitamin status was normal: 592.6 +/- 522 pg/ml vitamin B(12) and 10.5 +/- 5.5 ng/ml folic acid. Mean microalbuminuria was 81.7 +/- 238 mg/day. The calorie intakes were normal (carbohydrates 43%, proteins 23.8%, and lipids 33.1%). A decrease in daily intakes of vitamins (A, B(1), D, and E) and trace elements (Zn, Mg, Se, and Ca) was detected. High daily intakes were detected for protein, P, and vitamins C, B(12), K and P 29.7% of the patients drank beer and 18% other alcoholic beverages. 11.7% of the patients smoked, and 77.7% maintained daily physical activity (mean/day 25.7 +/- 20.9 min). Only protein (g/day; r = 0.25; p < 0.005) and beer (ml/day; r = -0.46; p < 0.05) correlated with the total homocysteine levels. The daily intakes of vitamin B(12) and folic acid were inversely correlated with the total homocysteine levels: r = -0.29; p < 0.05) and (r = -0.12; p < 0.05), respectively. Physical activity and smoking habits were not correlated. In the multivariate analysis with a dependent variable (total homocysteine) adjusted for age, sex, microalbuminuria, and nutrient intakes (proteins, folic acid, and vitamin B(12)) and beer remained in the model. CONCLUSION: The present study shows that protein intake and beer could modify the levels of total homocysteine in patients with diabetes type 2.
