Serum homocysteine concentration is related to diabetes mellitus, but not to coronary heart disease, in Saudi Arabians

Al-Nozah, M.; Al-Daghri, Nasser M.; Bartlett, William A.; Al‐Attas, Omar S.; Al-Maatouq, Mohamed A.; Martin, Steven C.; Kumar, Sudhesh; Jones, Alan

doi:10.1046/j.1463-1326.2002.00191.x

Cited by 9 publications

(7 citation statements)

References 42 publications

(37 reference statements)

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“…In all groups, there was a strong negative association between the HCYS level and a family history of diabetes as well as between HCYS and glucose levels. This reaffirms our previous findings that serum HCYS is lower in Saudi patients with diabetes mellitus because HCYS levels of subjects who are genetically predisposed to develop diabetes also have lower HCYS levels [35].…”

Section: Discussionsupporting

confidence: 91%

Homocysteinemia, hypertension, and family history of diabetes in a smoking male population in Saudi Arabia

Al-Daghri

Al‐Attas

2008

Open Medicine

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AbstractArabs have a lower incidence of atherosclerosis than other ethnicities, but few studies have examined homocysteine (HCYS) as a risk factor for cardiovascular disease in this population. Here, we investigated the association between serum HYCS levels and risk factors for cardiovascular disease (smoking, hypertension, and family history of diabetes) in Saudi males. A total of 50 smokers and 72 nonsmokers completed a general health questionnaire. In addition, their lipid profiles were measured using routine methods and HCYS levels by high-performance liquid chromatograph with electrochemical detection. Regression analysis showed negative associations between HCYS and glucose (r = −0.22; P < 0.05) as well as family history of diabetes (r = −0.21; P < 0.05). HCYS levels were similar between hypertensive and nonhypertensive smokers, but they were significantly elevated in hypertensive nonsmokers (P = 0.027) and lower in smokers with family history of diabetes (P = 0.01). Levels of HCYS among nonsmokers inversely correlated with history of diabetes and elevated glucose. Nonsmokers’ HCYS levels were significantly elevated in the presence of hypertension and correlated with diastolic blood pressure. Thus, HCYS may be a predictor of hypertension among nonsmokers. Until further trials are conducted, we recommend vitamin B6/folic acid supplementation for the Saudi hypertensive population as an adjuvant therapy.

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Section: Discussionsupporting

confidence: 91%

Homocysteinemia, hypertension, and family history of diabetes in a smoking male population in Saudi Arabia

Al-Daghri

Al‐Attas

2008

Open Medicine

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“…The study by Al-Nozha et al (2002) assessed the level of homocysteine, the independent vascular risk factor, and found that it is lower in Saudi diabetic patients, 53 in contrast to the study by Ajabnoor et al 54 Interestingly, Ajabnoor et al showed a linear relationship between LDL and homocysteine, an observation documented before in young menstruating Caucasian females. 55 More data is needed to resolve this disparity.…”

Section: Specific Diabetes Syndromesmentioning

confidence: 92%

Epidemiology, Clinical and Complications Profile of Diabetes in Saudi Arabia: A Review

Elhadd

Al-Amoudi

Alzahrani

2007

Annals of Saudi Medicine

104

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Diabetes mellitus is emerging as a major public health probelm in Saudi Arabia in parallel with the worldwide diabetes pandemic, which is having a particular impact upon the Middle East and the third world. This pandemic has accompanied the adoption of a modern lifestyle and the abandonment of a traditional lifestyle, with a resultant increase in rates of obesity and other chronic non-communicable diseases. The indigenous Saudi population seems to have a special genetic predisposition to develop type 2 diabetes, which is further amplified by a rise in obesity rates, a high rate of consanguinity and the presence of other variables of the insulin resistance syndrome. We highlight the epidemiology, clinical and complications profiles of diabetes in Saudi people. Diabetes is well studied in Saudi Arabia; however, there seems to be little research in the area of education and health care delivery. This is of paramount importance to offset the perceived impact on health care delivery services, to lessen chronic diabetes complications, and to reduce the expected morbidity and mortality from diabetes.

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“…Five studies have related hyperhomocysteinemia specifically to coronary heart disease in diabetes. 11,41,54,77,78 Smulders et al found a higher plasma homocysteine concentration in subjects with than in those without coronary artery disease (13.0 vs. 10.0 µmol/L, p = 0.02). 11 In a coronary angiography study by Okada et al, there was a strong correlation between the extent of coronary abnormalities and plasma homocysteine level in 46 patients who had diabetes (r = 0.388, p = 0.011), while this relationship was weaker and did not reach significance (r = 0.185, p = 0.068) in 99 subjects without diabetes.…”

Section: Figmentioning

confidence: 96%

“…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.…”

Section: Determinants Of Plasma Homocysteine Concentrationmentioning

confidence: 99%

“…77 In contrast to the previous three studies, in a study among Saudi Arabian subjects with type 2 diabetes, homocysteine concentrations were comparable for patients with and without coronary heart disease. 54 Carotid artery disease was studied by Mazza et al, who performed carotid ultrasonography in 130 subjects with type 2 diabetes with a mean age of 53 years and diabetes duration of 11 years. 13 No significant association was found between intima-media thickness of the common carotid artery or the presence of plaque and plasma homocysteine level.…”

Section: Figmentioning

confidence: 99%

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Epidemiology of Homocysteine as a Risk Factor in Diabetes

Becker

Smulders²,

Guldener³

et al. 2003

Metabolic Syndrome and Related Disorders

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Patients with diabetes mellitus are prone to cardiovascular disease, and risk factors presumably unrelated to diabetes, such as hyperhomocysteinemia, may be involved in the atherothrombotic process in these subjects. Plasma homocysteine levels are usually normal in diabetes, although both lower and higher levels have been reported. This has been ascribed to hyperfiltration and renal dysfunction or low folate status, respectively. Insulin resistance does not appear to be a major determinant of plasma homocysteine level. Hyperhomocysteinemia has been associated with microalbuminuria and retinopathy in type 1 and type 2 diabetes. In patients with type 2 diabetes, plasma homocysteine concentration has also been shown to be related to macrovascular disease and death. This relation seems to be stronger in subjects with diabetes than without. The underlying pathophysiological mechanism of this increased vascular risk remains unexplained, but may relate to worsening of endothelial dysfunction or structural vessel properties. Because homocysteine and diabetes have an apparent synergistic detrimental vascular effect, patients with diabetes are good candidates for screening and treatment with folic acid until the results of ongoing clinical trials are available.

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Serum homocysteine concentration is related to diabetes mellitus, but not to coronary heart disease, in Saudi Arabians

Abstract: In the Saudi Arabian population, serum HCYS is not a risk factor for CHD, but is lower in patients with DM.

Cited by 9 publications

References 42 publications

Homocysteinemia, hypertension, and family history of diabetes in a smoking male population in Saudi Arabia

Homocysteinemia, hypertension, and family history of diabetes in a smoking male population in Saudi Arabia

Epidemiology, Clinical and Complications Profile of Diabetes in Saudi Arabia: A Review

Epidemiology of Homocysteine as a Risk Factor in Diabetes

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