Plasma homocysteine concentrations in patients with type 1 diabetes.

Abstract

Subnormal tHcy concentrations in male patients, the absence of a sex difference, and the positive association with age indicate that homocysteine metabolism differs between type 1 diabetic patients and control subjects. Homocysteine is unlikely to be of pathogenic significance in patients, particularly male subjects, with early microvascular disease and/or neuropathy.

Total Homocysteine, Diet, and Lipid Profiles in Type 1 and Type 2 Diabetic and Nondiabetic Adolescents

“…Studies indicate that adults with type 1 DM without evidence of nephropathy have plasma tHcy levels lower than, comparable to, or higher than healthy non-DM controls. [23][24][25][26][27] Renal status varies in persons with DM related to hyperglycemia, duration of diabetes, and progression of nephropathy, reflecting periods of glomerular hyperfiltration and impaired renal function. In a recent study of adults with type 1 DM, plasma tHcy levels were noted to be significantly lower in the subjects with diabetes than in the subjects with diabetic renal disease and elevated creatinine levels or the non-DM healthy controls.…”

Endothelial Dysfunction Relates to Folate Status in Children and Adolescents With Type 1 Diabetes

“…Reduced tHcy concentrations have been found in some populations of adults with type 1 diabetes (12,13). Glomerular hyperfiltration has been proposed as the mechanism (14).…”

Epidemiology of Homocysteine as a Risk Factor in Diabetes

“…In patients with type 1 diabetes, some authors have found a significant association between urinary albumin excretion and plasma homocysteine level, 45,46,50,58 while others have not. 55,59 Controversial findings have also been reported in type 2 diabetes with some investigators finding a significant relation between albuminuria and plasma homocysteine level, 34,49,60 while others did not. 11,27,31,61,62 The discrepancies between these studies may relate to the cross-sectional design with limited numbers of patients of different ethnic background, comorbidity, renal function, and vitamin status.…”

“…Studies which have measured renal function and vitamin status in diabetic patients and control subjects suggest that they have similar plasma homocysteine levels. 45,50,55 This is in agreement with observations from the Hoorn Study, a large population-based study of glucose tolerance and cardiovascular disease in 50-75-yearold subjects in The Netherlands, which showed that the median plasma homocysteine level was similar in subjects with normal glucose tolerance (11.2 µmol/L, interquartile range (IQR) 9.2-14.4, n = 288), impaired glucose tolerance (12.2 µmol/L, IQR 9.7-14.5, n = 170) and diabetes mellitus (11.2 µmol/L, IQR 9.2-13.6, n = 173). 57 In contrast, two studies reported a significantly lower homocysteine concentration in diabetic patients on hemodialysis compared to nondiabetic patients on hemodialysis after adjustment for creatinine, but not for folate, in serum.…”

“…Some authors have reported higher homocysteine levels in diabetic patients, 15,16,[41][42][43][44][45][46] while others have found similar 14,45,[47][48][49][50] or even lower levels. 35,[51][52][53][54][55][56] These discrepancies may be due mainly to the fact that most studies did not account for folate status and renal function, the two most important determinants of plasma homocysteine level. Correction for renal function is important, because even small changes in glomerular filtration rate have a significant impact on plasma homocysteine level.…”