Homocysteine and other biochemical parameters in Type 2 diabetes mellitus with different diabetic duration or diabetic retinopathy

Huang, Erh Jung; Kuo, Wei Wen; Chen, Yuh Jyuan; Chen, Ter Hsin; Chang, Mu Hsin; Lü, Min; Tzang, Bor‐Show; Hsu, Hsi Hsien; Huang, Chih Yang; Lee, Shin-Da

doi:10.1016/j.cca.2005.10.025

Cited by 77 publications

(59 citation statements)

References 17 publications

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“…Second, there is a potential link of DR with an enhanced release of free fatty acid. 40 It remains uncertain whether free fatty acid status affected the risk of DR in type 2 diabetes patients, because we did not examine the free fatty acid concentration in this investigation. Third, an aldose reductase inhibitor, epalrestat, has been proven to improve peripheral sensory nerve impairments in diabetes mellitus.…”

Section: Discussionmentioning

confidence: 97%

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

et al. 2009

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Diabetic retinopathy (DR) and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This preliminary study was therefore designed to test the hypothesis that DR is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients without insulin treatment. Seventy persons were diagnosed to have type 2 diabetes in the examination from June 2004 to May 2006. The study group consisted of 29 type 2 diabetic patients with DR (age: 58 ± 6 years, mean ± s.d.) and 41 type 2 diabetic patients with no DR (NDR) (n¼41, 58 ± 5 years). Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability, plasma norepinephrine concentration and cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphic findings. DR patients had lower BRS, early and delayed 123 I-MIBG myocardial uptake values and higher percent washout rate (WR) of 123 I-MIBG than the NDR patients. With respect to metabolic findings, DR patients had higher fasting plasma insulin concentration (Po0.0001) and higher homeostasis model assessment (HOMA) index (Po0.00001) than the NDR patients. Multiple logistic regression analysis revealed that the presence of DR was independently predicted by HOMA index and the percent WR of 123 I-MIBG (Po0.01 and Po0.05, respectively). Our results suggest that DR is associated with depressed cardiovascular autonomic function and insulin resistance and that HOMA index and the percent WR of 123 I-MIBG are independently associated with DR in Japanese patients with type 2 diabetes mellitus.

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Section: Discussionmentioning

confidence: 97%

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

et al. 2009

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“…In contrast, plasma or sera have remained the biofluid of choice in metabonomic studies. With these biological matrices, several research groups have reported metabolite markers of global (25,26) and targeted (27)(28)(29) metabonomic analysis. These studies, however, did not account for confounders and comorbidities, such as medication use and kidney disease.…”

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confidence: 99%

Plasma Metabonomic Profiling of Diabetic Retinopathy

et al. 2016

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Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and the leading cause of visual impairment in working-age adults. Patients with diabetes often develop DR despite appropriate control of systemic risk factors, suggesting the involvement of other pathogenic factors. We hypothesize that the plasma metabolic signature of DR is distinct and resolvable from that of diabetes alone. A nested populationbased case-control metabonomic study was first performed on 40 DR cases and 40 control subjects with diabetes using gas chromatography-mass spectrometry. Eleven metabolites were found to be correlated with DR, and the majority were robust when adjusted for metabolic risk factors and confounding kidney disease. The metabolite markers 2-deoxyribonic acid; 3,4-dihydroxybutyric acid; erythritol; gluconic acid; and ribose were validated in an independent sample set with 40 DR cases, 40 control subjects with diabetes, and 40 individuals without diabetes. DR cases and control subjects with diabetes were matched by HbA 1c in the validation set. Activation of the pentose phosphate pathway was identified from the list of DR metabolite markers. The identification of novel metabolite markers for DR provides insights into potential new pathogenic pathways for this microvascular complication and holds translational value in DR risk stratification and the development of new therapeutic measures.Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and the leading cause of visual impairment in working-age adults worldwide (1,2). The global prevalence of diabetes is rising and the number of people with diabetes is projected to increase by 54% in 2030, compared with 2010 (3). The public health burden of diabetes and DR would thus increase correspondingly. The major risk factors of DR are poor glycemic control and hypertension, as well as the duration of diabetes (4,5), but their relative importance varies between studies (2,6). Although the risks of DR progression and vision loss are reduced with intensive control of risk factors (7,8), many patients with diabetes continue to develop complications despite tight glycemic and blood pressure control. There is increasing evidence to suggest that "metabolic memory" is responsible for this observation. The term metabolic memory refers to the persistent epigenetic modifications caused by early exposure to hyperglycemia that, in turn, predispose individuals to the development of diabetes complications even after good glycemic control

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“…Several studies have reported that tHCY is linked to vaso-occlusive disorders in the eye (16)(17)(18) and may represent a useful biomarker or a novel risk factor for increased risk of DR in patients with T2DM (19)(20)(21)(22). Some studies, however, do not support this conclusion (23,24) Low concentrations of B vitamins are associated with increased risk of vascular damage possibly through HCY, including vaso-occlusive diseases of the eye.…”

Section: Introductionmentioning

confidence: 55%

“…Other studies showed no relation between tHCY concentrations and incidence of retinopathy of any grade but there was an association between increased tHCY and incidence of proliferative retinopathy (19). It was shown that HHCY may be a risk factor for the development and progression of retinopathy in T2DM (21). There are many studies have evaluated the association between tHCY and the incidence of DR, the results are varied and inconsistent (19,22,34), in some studies this relation seems to be confounded by nephropathy (35).…”

Section: Discussionmentioning

confidence: 99%

Influence of Retinopathy on Plasma Concentrations of total Homocysteine and other Biochemical Parameters in Algerian Patients with Type 2 Diabetes Mellitus

et al. 2012

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Homocysteine (HCY) has been identified as a risk factor for vascular disease in the general population. Diabetic retinopathy (DR) itself rather than hyperhomocysteinemia is the leading cause of blindness among patients with type 2 diabetes mellitus (T2DM). Our study was conducted with 60 healthy control subjects and 178 subjects with T2DM. They were enrolled in the Diabetes Prevention Program from September 2007 to December 2008. Of the 178 patients, 121 cases (68%) had DR Mean plasma total HCY (tHCY) levels were found to be higher in T2DM patients compared to controls (p <0.001), and were also higher than that of the DR group (p <0.001). Plasma folic acid levels were lower in the DR group compared with T2DM without DR and the control group (p <0.001), but there were no significant differences between the latter and the controls. Moderate hyperhomocysteinemia was significantly associated with lower vitamin B12 and folic acid concentrations and older age. Concentrations of serum total cholesterol, LDL-cholesterol (LDL-C), and triglycerides (TG) were significantly raised (p <0.001) whereas the level of HDL-cholesterol (HDL-C) was decreased (p <0.001) in diabetic subjects as compared to controls. Logistic regression analysis showed that DR after adjustment was significantly associated with the following factors: cholesterol, HDL-C and TG. The analysis in DR patients after controlling for cholesterol and TG was independent of plasma tHCY concentrations (OR = 28.5 and OR = 11.9; respectively). In conclusion, results suggest a possible association between moderate hyperhomocysteinemia, traditional risk factors and folic acid deficiency could be an independent risk factor for DR.

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Homocysteine and other biochemical parameters in Type 2 diabetes mellitus with different diabetic duration or diabetic retinopathy

Cited by 77 publications

References 17 publications

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

Plasma Metabonomic Profiling of Diabetic Retinopathy

Influence of Retinopathy on Plasma Concentrations of total Homocysteine and other Biochemical Parameters in Algerian Patients with Type 2 Diabetes Mellitus

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