Total homocysteine in patients with type 1 diabetes.

Abstract

OBJECTIVE: Our aim was to study the presence of moderate hyperhomocysteinemia, a risk factor for premature cardiovascular disease, its modifying vitamin factors (folates, vitamins B12 and B6), and lipid risk factors in juvenile type 1 diabetes. RESEARCH DESIGN AND METHODS: A total of 91 patients with type 1 diabetes (46 girls and 45 boys) were studied, with ages ranging from 11 to 18 years, a duration of diabetes from 1 to 15 years, and in pubertal development (stages III, IV, V). In all patients, cholesterol, triglycerides, HDL and LDL cholesterol, lipoprotein(a), folates, cobalamin, vitamin B6, and total homocysteine were determined by specific assays. Microalbuminuria, defined as a ratio of albumin/creatinine >3 mg/mmol creatinine, was analyzed in the first morning specimen. RESULTS: Plasma total homocysteine (tHcy) concentrations were not different in the 91 diabetic children (median [range]) (11-15 years, 6.1 micromol/l [3.2-9.6]; 16-18 years, 7.3 micromol/l [3.9-12]) compared with the control group (11-15 years, 6.6 micromol/l [4.4-10.8]; 16-18 years, 8.1 micromol/l [4.6-11.3]). No significant differences were found in tHcy values in relation to the metabolic control of the disease as assessed by glycohemoglobin values, the duration of disease, alterations in fundus oculi, or presence of lymphocytic thyroiditis. A positive correlation was found between tHcy and plasma creatinine in type 1 diabetic patients that might be related with the increase in muscle mass. There was a negative correlation between tHcy and serum folate (P<0.001) and vitamin B12 (P<0.05), but not with vitamin B6 levels. No significant correlations were found between tHcy and the lipid parameters. CONCLUSIONS: Hyperhomocysteinemia was not detected in adolescents with type 1 diabetes.

Hyper-homocysteinemia is Not a Main Feature of Juvenile Uncomplicated Type 1 Diabetes

“…In conclusion our results confirm recent data, which report normal level of plasma Hcy in T1DM patients (23). In any case, considering that a trend to higher values of plasma tHcy with the age (r 2 = 0.17, p < 0.001) is more significant in young T1DM than in our control group of the same age, we suggest in such a metabolic situation, the measure of plasma tHcy levels in order to prevent the endothelial damage.…”

Proteinuria as a Predictor of Total Plasma Homocysteine Levels in Type 2 Diabetic Nephropathy

“…This study found that HbA 1c is inversely predictive of tHcy levels, although previous investigations have reached conflicting results with regard to glycemic markers in patients with diabetes. Some investigations have found that these markers are positively correlated with tHcy levels (35,36), others have found a negative correlation (37), and still others have found no significant relationship (15,38). The cause of the inverse relationship found here is not obvious.…”

Effect of L-methionine supplementation on plasma homocysteine and other free amino acids: a placebo-controlled double-blind cross-over study

“…With regard to the role of vitamins in the metabolism of methionine, significant inverse relations between at least one of the vitamins involved (folate, B 12 and B 6 ) and plasma tHcy have often been found (Andersson et al, 1992;Ubbink et al, 1998;Pavia et al, 2000;Lim & Heo, 2002;Houcher et al, 2003;Huang et al, 2003;Samman et al, 2003). Laboratory indices of folate (serum folate and RBC-folate), vitamin B 12 and vitamin B 6 showed an adequate supply with these vitamins.…”