Homocysteine Concentrations in Type 2 Diabetes Mellitus Patients Without Cardiovascular Disease: Relationship to Metabolic Parameters and Diabetic Complications

The increased coronary heart disease (CAD) risk in subjects with type 2 diabetes was partly explained by an association with established risk factors like hypertension, hyperlipidemia and obesity. An increased plasma homocysteine level was accepted as an important risk factor for vascular disease, including coronary atherosclerosis. However, there was no data about the importance of homocysteine levels in type 2 diabetic patients without CAD. The aim of this study was, to determine the association between plasma homocysteine concentrations and metabolic parameters and diabetic complications in type 2 diabetic patients without CHD. Thirty eight (23 women, 15 men) type 2 diabetic patients without CHD were included to the study. In patient group, routine biochemical and hematological tests, thyroid function tests, HgbA1c, microalbuminuria, vit B12, folic acid and homocysteine levels were assessed. Patients were evaluated for diabetic complications. Age and sex matched, 25 (15 women, 10 men) healthy control subjects were included to study, in order to compare the homocysteine levels with patient group. There was no statistically significant difference in plasma homocysteine concentrations between patient and control group. However, there were more hyperhomocysteinemic patient in diabetic group than control subjects (10.5% vs 4%). There was no association between plasma homocysteine levels and age, duration of diabetes, fasting plasma glucose, post-prandial plasma glucose, urea, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and HgbA1c levels. There was an association between homocysteine and serum creatinine and also microalbuminuria levels (p<0,05). Homocysteine concentrations were not associated with diabetic retinopathy and neuropathy. A relation between homocystein levels and hypertension was observed. As a result, type 2 diabetes mellitus does not alter the homocysteine concentrations but with the occurance of complications like hypertension and microalbuminuria, concentrations tend to increase.