Homocysteine is related to peripheral arterial disease only in male elderly with type 2 diabetes mellitus

Abstract

a b s t r a c tPurpose: To find out a novel risk factor for peripheral arterial disease (PAD) in the elderly with Type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study involving 70 out of 146 elderly (!60 years) with T2DM whose ankle ebrachial index (ABI) was measured at the Geriatric Out-patient Clinic, Sanglah Hospital. Results: The overall prevalence of PAD was 30.8% (45 out of 146); in males, it was 25.88% (22 out of 85) and in females, 37.70% (23 out of 61). Only 70 out of 146 subjects who had complete data were further analyzed. By bivariate correlation test, it was found that age (right ABI: r ¼ À0.396, p < 0.001; left ABI, r ¼ À0.509, p < 0.001); lying systolic blood pressure (right ABI: r ¼ À0.268, p ¼ 0.012; left ABI: r ¼ À0.267, p ¼ 0.013); and concentration of 2-hours post-prandial (2-hpp) plasma glucose (right ABI: r ¼ À0.252, p ¼ 0.018) had inverse correlation with ABI, whereas waist circumference, body mass index, sitting and standing systolic and diastolic blood pressures, lying diastolic blood pressure, levels of total cholesterol, low-density-lipoprotein (LDL) cholesterol, high-density-lipoprotein (HDL) cholesterol, triglyceride, fasting plasma glucose, haemoglobin A1C (A1C), and duration of diabetes, had no correlation with ABI. The ages of subjects who had PAD were greater than those without PAD (71.5 years vs. 65.2 years, p < 0.001). Homocysteine tended to be correlated only with left ABI (r ¼ À0.198; p ¼ 0.050), but after assessment on sex factor, it showed that homocysteine had inverse correlation with ABI in males (right ABI: r ¼ À0.371, p < 0.026; left ABI: r ¼ À0.358, p ¼ 0.032). Homocysteine also had a positive correlation with age (r ¼ 0.315, p ¼ 0.004). By multiple regression test, age, LDL cholesterol, and 2-hpp plasma glucose had a role in the PAD event.Conclusions: Some traditional risk factors (age, lying systolic blood pressure, LDL cholesterol, and 2-hpp plasma glucose) were related with PAD in the elderly with T2DM. Homocysteine as a novel risk factor had a correlation with ABI only in the male subjects. Age was the most important risk factor for PAD, either directly or indirectly through homocysteine (only in males).

Serum Homocysteine Level in Type 2 Diabetes Mellitus with Peripheral Arterial Disease

“…We found that serum homocysteine level in cases was significantly higher than that of controls (p<0.001). These results were similarly reported by other workers of different countries 12,13,14 .…”

The Role of Triglyceride in Cardiovascular Disease in Asian Patients with Type 2 Diabetes - A Systematic Review

“…In studies conducted in Taiwan, Indonesia, and South India, neither total cholesterol, HDL-C, LDL-C, nor TG were associated with PAD in multivariate regression models (Tables 2 and 3) [26,27,30].…”

“…The abstracted data from the 10 studies are listed in Tables 2 and 3 according to the fixed protocol. In these ten studies, five focused on CHD, three on stroke, three on PAD, one on CVD, and one on CVD related mortality [15,16,[24][25][26][27][28][29][30][31]. The findings on the association of TG and CVD are discussed as follows.…”

Profile and analysis of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, Jakarta

“…23 Other risk factors which were not assessed in this study are age and homocystein level, while these two variables are correlated with peripheral arterial disease in type 2 diabetes patients. 24 These findings have controlled several important variables like clinical characteristics and http://mji.ui.ac.id diabetes therapy. The duration is also related to the coronary disease risk and its increased mortality rate.…”