Genetically elevated circulating homocysteine concentrations increase the risk of diabetic kidney disease in Chinese diabetic patients

Ma, Liang; Liu, Qian; Jiang, Yongwei; Zhao, Hailing; Zhao, Tingting; Cao, Yongtong; Li, Ping; Niu, Wenquan

doi:10.1111/jcmm.14187

Cited by 20 publications

(12 citation statements)

References 32 publications

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“…Their observations suggest that increased plasma tHcy levels are associated with an increased DKD risk in Chinese diabetic patients. [ 30 ]…”

Section: Discussionmentioning

confidence: 99%

Relationship between plasma total homocysteine and the severity of renal function in Chinese patients with type 2 diabetes mellitus aged ≥75 years

Yin

et al. 2020

Medicine

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We aimed to investigate the relationship between total homocysteine (tHcy) levels in the plasma and renal function severity in patients with type 2 diabetes mellitus (T2DM) aged ≥75 years. We included 221 patients with T2DM aged ≥60 years (59 aged ≥75 years). tHcy levels among the 4 groups of patients aged ≥60 years significantly differed, but not in those aged ≥75 years. tHcy levels in patients aged ≥60 years were negatively correlated with the estimated glomerular filtration rate. The area under the receiver operating characteristic curve of tHcy for predicting diabetic kidney disease (DKD) was 0.636. Fasting c-peptide and creatinine were independently associated with tHcy levels in patients aged ≥60 years, whereas insulin and creatinine were independently associated with tHcy levels in those aged ≥75 years. tHcy concentrations were elevated in T2DM and can potentially serve as a risk factor for DKD, but it is not an ideal biomarker.

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“…Their observations suggest that increased plasma tHcy levels are associated with an increased DKD risk in Chinese diabetic patients. [ 30 ]…”

Section: Discussionmentioning

confidence: 99%

Relationship between plasma total homocysteine and the severity of renal function in Chinese patients with type 2 diabetes mellitus aged ≥75 years

Yin

et al. 2020

Medicine

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“…If the glomerulus of the body is damaged, its level will increase rapidly and be positively correlated with the degree of injury (20,21). Hcy is one of the risk factors of vasculopathy (22). When vascular endothelial injury occurs, the risk of diabetic nephropathy increases.…”

Section: Discussionmentioning

confidence: 99%

Effects of insulin combined with metformin on serum cystatin C, homocysteine and maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus

Zheng

Zhang

et al. 2019

Exp Ther Med

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Effects of insulin combined with metformin on serum cystatin C (Cys C), homocysteine (Hcy) and maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus (GDM) were investigated. In total, 80 cases of pregnant women diagnosed with GDM in the Department of Obstetrics and Gynecology of Liaocheng Third People's Hospital from July 2015 to July 2017 were selected and divided into a study group (42 cases) and a control group (38 cases). The study group was treated with insulin combined with metformin, and the control group was treated with insulin. Fasting blood glucose (FBG) and postprandial blood glucose after 2 h (2hPG) of the two groups were compared before and after treatment. Levels of serum Cys C, Hcy, urinary protein (UmAlb), postpartum maternal outcomes and adverse reactions during pregnancy were compared in the two groups before and after treatment. After treatment, the level of FBG and 2hPG in the control group was higher than that in the treatment group (P<0.05). After treatment, the level of serum Cys C and Hcy in both groups were lower than that before the treatment, and the level in the study group was lower than that in the control group (P<0.05). The total incidence of neonatal adverse outcomes and the number of adverse pregnancies in GDM patients in the study group were significantly lower than those in the control group (P<0.05). There were no significant differences in adverse reactions during pregnancy between the two groups (P>0.05). In conclusion, insulin combined with metformin is more effective than insulin alone in reducing serum Cys C and Hcy levels, with significant effect on the improvement of maternal and neonatal outcomes.

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“…With regards to MTHFR 1298A>C only one meta-analysis performed in which no association between MTHFR 1298A>C and DN risk was observed (44). Higher levels of homocysteine in patients with DN were demonstrated in multiple studies (46)(47)(48). This is further supported by presence of increased erythrocyte S-Adenosyl-L-homocysteine, decreased erythrocyte S-Adenosyl methionine and lymphocyte MTHFR activity in patients with advanced nephropathy (49).…”

Section: Sensitivity Analysis and Publication Biasmentioning

confidence: 96%

Association between the methylenetetrahydrofolate reductase (MTHFR) gene 677C>T and 1298A>C polymorphisms and the risk of diabetic nephropathy; a meta-analysis

Gupta

Sharma

Lakkakula³

et al. 2019

J Renal Inj Prev

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Methylenetetrahydrofolate reductase (MTHFR) is involved in the homocysteine metabolism. Two common variants of MTHFR gene (677C>T and 1298A>C), have been reported to reduce the MTHFR enzyme activity and leading to plasma hyperhomocysteinemia. There are a number of recent case-control studies that investigated the association between the MTHFR polymorphism and diabetic nephropathy (DN), albeit with inconsistent results. The aim of this meta-analysis is to evaluate the associations between the genetic polymorphisms of MTHFR with susceptibility to DN. A literature search was conducted on PubMed, Embase and Google scholar from inception till March 18, 2019. For MTHFR 677C>T analysis, a total of 23 studies including DM controls (3095 cases and 3187 DM controls) and 12 studies including non-DM controls (1590 cases and 2052 nonDM controls) were taken. For MTHFR 1298A>C analysis, a total of 7 studies using DM controls (959 cases and 1209 DM controls) and 3 studies using non-DM controls (400 cases and 802 nonDM controls) were taken. Meta-analysis showed that mutant genotypes of the 677C>T (OR: 1.58; 95%CI: 1.16-2.14) and 1298A>C (OR: 1.38; 95%CI: 1.16-1.65) polymorphisms in the MTHFR gene were associated with increased risk of DN (diabetic kidney disease). MTHFR 677C>T and 1298A>C polymorphisms revealed significant heterogeneity between studies. Further, there was no evidence for publication bias for these polymorphisms. In conclusion, this meta-analysis provides strong evidence that MTHFR 677C>T and 1298A>C polymorphisms may be associated with increased risks of DN. However, further studies are still needed to accurately determine whether MTHFR genetic polymorphisms are associated with susceptibility to DN.

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Genetically elevated circulating homocysteine concentrations increase the risk of diabetic kidney disease in Chinese diabetic patients

Cited by 20 publications

References 32 publications

Relationship between plasma total homocysteine and the severity of renal function in Chinese patients with type 2 diabetes mellitus aged ≥75 years

Relationship between plasma total homocysteine and the severity of renal function in Chinese patients with type 2 diabetes mellitus aged ≥75 years

Effects of insulin combined with metformin on serum cystatin C, homocysteine and maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus

Association between the methylenetetrahydrofolate reductase (MTHFR) gene 677C>T and 1298A>C polymorphisms and the risk of diabetic nephropathy; a meta-analysis

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