Abstract
Introduction: Raised serum homocysteine levels have been found to be risk factor for cardiovascular diseases. In the present study we have tried to assess the correlation of serum homocysteine levels with microvascular complications in patients of Type 2 diabetes mellitus.
Materials and Methods: A total of 80 randomly selected Type 2 diabetes patients were grouped into two categories: Group A consisted of those patients who had diabetes with microvascular complication and Group B included diabetic patients without any complication. Group C (controls) included 20 healthy age and sex matched subjects. Detailed history was taken and thorough clinical examination was done with relevant investigations.
Results: Significant positive correlation was found between duration of diabetes and serum homocysteine levels (Chi square value = 7.0839 with p-value 0.02). Inter –group analysis of mean homocysteine levels showed that homocysteine levels in patients having all the three microvascular complications were highest as compared to rest of the patients (F value = 8.26 and p value = 0.000). Correlation between homocysteine levels and HbA1C levels was not significant.
Conclusion: It could be concluded from the present study that a moderate positive correlation exists between duration of diabetes and serum homocysteine levels. The levels of serum homocysteine correlated positively with microvascular complications of diabetes. Thus serum homocysteine could be used as surrogate biomarker for diabetic microvascular complications.
Keywords: Type 2 diabetes , serum homocysteine , microvascular complications, diabetes in western UP
References
- IDF Diabetes Atlas. 6th edition update. International Diabetes Federation. Key findings 2014.
- Drzewoski J, Czupryniak L, Chwotko G, Bold F. Hyperhomocysteinemia in poorly controlled type 2 diabetes patients. Diabetes Nutr Metab. 2000;13(6):319-24
- Wald NJ, Watt HC, Law MR, Weir DG, McPartlin J, Scott JM. Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med. 1998;158:862-7
- Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M, Vollset SE. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med.1997;337:230-6
- Hankey GJ, Eikelbom JW. Homocysteine and stroke. Curr Opin Neurol.2001;14:95-102
- Laralie J, Ray JG, Evrovski Yeo E, Cole DE. Hyperhomocysteinemia and the increased risk of venous thrombolem-bolism. Arch Int Med.2000;160:961-4
- Male-khosravi S, Kaboudi M, Kaboudi B, Atefi G. Plasma homocysteine concentrations and insulin resistance in preeclampsia. Hyperten Pregnancy. 2009; 28(1):13-22
- Patterson S, Flatt PR, Brennan L, Newsholme P, McClenaghan NH. Detrimental actins of metabolic syndrome risk factor, homocysteine, on pancreatic beta cell glucose metabolism and insulin secretion. J Endocrinol.2006;189(2):301-10
- Patterson S, Flatt PR, McClenaghan NH. Homocysteine induced impairment of insulin secretion from clonal pancreatic BRIN-BD11 beta-cells is not prevented by catalase. Pancreas.2007;34(1):144-51
- Boushey CJ, Beresford SAA, Omenn GS, et al. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA.1995;274:1049-57
- Mohan V, Ravikumar R, Shanthi RS, Deepa R. Intimal medial thickness of the carotid artery in south Indian diabetic and non-diabetic subjects: the Chennai Urban Population Study(CUPS).Diabetologia.2000;43:494-9
- Misra A, Reddy RB, Reddy KS et al. Clustering of impaired glucose tolerance, hyperinsulinemia and dyslipidemia in young north Indian patients with coronary artery disease: A preliminary case control study. Indian Heart Journ.1999;51:275-80
- Sheikh et al. Plasma homocysteine levels in patients with diabetes mellitus. World Applied Sciences Journal.2012; 16(9):1269-73
- Fahmy E, Amer H, Rabah AM et al. Estimation of serum homocysteine level in patients with Type 2 diabetic neuropathy. Egypt J Neurol Psychiat Neurosurg. 2010;47:59-66
- Ramchandran L, Negi NS, Gupta B. Prevalence of hyperhomocysteinemia in Type 2 diabetes and its correlation with its complications. JIACM.2012;13(4):227-81
Corresponding Author
Dr Alankar Tiwari
Senior Resident, Department of Human Metabolism and Endocrinology, Meerut UP