Plasma total homocysteine and carotid intima-media thickness in type 1 diabetes: A prospective study

Abstract

OBJECTIVE Plasma homocysteine (tHcy) has been positively associated with carotid intima-media thickness (IMT) in non-diabetic populations and in a few cross-sectional studies of diabetic patients. We investigated cross-sectional and prospective associations of a single measure of tHcy with common and internal carotid IMT over a 6-year period in type 1 diabetes. RESEARCH DESIGN AND METHODS tHcy levels were measured once, in plasma obtained in 1997-1999 from patients (n=599) in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, the observational follow-up of the Diabetes Control and Complications Trial (DCCT). Common and internal carotid IMT were determined twice, in EDIC “Year 6” (1998-2000) and “Year 12” (2004-2006), using B-mode ultra-sonography. RESULTS After adjustment, plasma tHcy [median (interquartile range): 6.2 (5.1, 7.5) μmol/L] was significantly correlated with age, diastolic blood pressure, renal dysfunction, and smoking (all p<0.05). In an unadjusted model only, increasing quartiles of tHcy correlated with common and internal carotid IMT, again at both EDIC time-points (p<0.01). However, multivariate logistic regression revealed no significant associations between increasing quartiles of tHcy and the 6-year change in common and internal carotid IMT (highest vs. lowest quintile) when adjusted for conventional risk factors. CONCLUSIONS In a type 1 diabetes cohort from the EDIC study, plasma tHcy measured in samples drawn in 1997-1999 was associated with measures of common and internal carotid IMT measured both one and seven years later, but not with IMT progression between the two time-points. The data do not support routine measurement of tHcy in people with Type 1 diabetes.

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

“…Laboratory inflammation markers have been used as predictive tools for atherosclerosis in patients with type 2 DM (36,(40)(41)(42)(43). In our study, we found no association between the inflammation markers hs-PCR and fibrinogen with subclinical atherosclerosis in patients with type 1 DM.…”

“…Nitric oxide, an oxidative stress marker, also correlated with CIMT in young patients with type 1 DM, suggesting a possible role of oxidative stress in the development of atherosclerosis (20). Data from the DCCT/EDIC study have shown in patients with type 1 DM that plasma homocysteine correlates with CIMT but not with CIMT progression; based on this finding, routine homocysteine measurement in patients with type 1 DM found no support (43). Thus, further studies are needed to evaluate the clinical impact of laboratory inflammation markers in the prediction of subclinical atherosclerosis in type 1 DM.…”

Hyperhomocysteinemia and Hyperuricemia are Closely Associated with a Decline in Renal Function in Patients with Type 2 Diabetes

“…This is supported by our finding that homocysteine level was higher in patients with hypertension and that it did not correlate with blood pressure values measured during hospitalization. Hyperglycemia, high blood pressure, and hyperhomocysteinemia [15,26,27] all accelerate atherosclerosis. Thus, we must assume that subjects with hyperhomocysteinemia have a long history of diabetes or hypertension and very high risk for atherosclerotic diseases.…”

Homocystein: A new biochemical marker in livestock sector

“…Boosted Hcy amounts effected intensity of Coronary arterial disease (Shenoy et al, 2014). Homocysteine has effect on endothelial malfunction and is consider to be intercede by factors consisting nuclear factor-kb (NF-kb) activation, provention of endothelial nitric oxide synthase, oxidative stress and inflammation (Basu et al, 2014). It is known that in a case of atherosclerosis, Carotid intima-media thickness is noninvasive factor (Basu et al, 2014).…”

“…Homocysteine has effect on endothelial malfunction and is consider to be intercede by factors consisting nuclear factor-kb (NF-kb) activation, provention of endothelial nitric oxide synthase, oxidative stress and inflammation (Basu et al, 2014). It is known that in a case of atherosclerosis, Carotid intima-media thickness is noninvasive factor (Basu et al, 2014). There is less dependence between total Hcy amounts and carotid intima media sickness in the nondiabetic groups, also it's known that the connection in the base of diabetes mellitus (DM) (Basu et al, 2014).…”