Total plasma homocysteine correlates in women with gestational diabetes

Aim We aim to assess serum total homocysteine (tHcy) associations with metabolic syndrome components and B-vitamins in women with gestational diabetes mellitus (GDM). Methods We studied 61 consecutive pregnant women, 44 with GDM and 17 with normal glucose tolerance (CG). Serum homocysteine levels were analyzed by ELISA, using Bio-Rad reagents. Serum folates and vitamin B-12 concentrations were determined by chemiluminescent immunoassay, free fatty acids (FFA) and lipids enzymatically. Results Serum homocysteine levels were similar in both the GDM and the CG groups (8 +/- 2.0 vs 7.4 +/- 1.1 mu mol/l, respectively). Women with GDM in comparison to CG women were characterized by higher values of homeostasis model of insulin resistance (HOMA-IR) (2.8 +/- 1.7 vs 1.6 +/- 0.9, P < 0.01), serum triglycerides (2.7 +/- 0.9 vs 1.9 +/- 0.5 mmol/l, P < 0.01) and FFA (0.6 +/- 0.2 vs 0.46 +/- 0.2 mmol/l, P < 0.05). In GDM women serum tHcy correlated with vitamin B-12 (r = -0.47, P < 0.01) and folates (r = -0.51, P < 0.001); in CG women with HOMA-IR, a marker of insulin resistance (r = -0.49, P < 0.05). In multiple regression analysis with serum tHcy as a dependent variable, folate and vitamin B-12 entered the analysis in GDM women (beta = -0.42 and -0.34, respectively, P < 0.05), whereas in CG cystatin C and HOMA-IR entered the analysis (P < 0.05). Conclusions In women with GDM, serum homocysteine is significantly associated with vitamin B-12 and folate levels, while in healthy pregnant women with HOMA-IR and with kidney function. The results suggest the importance of the B-group vitamins in regulation of serum tHcy levels in women with insulin resistance/gestational diabetes, what might be relevant in protection against pregnancy complications associated with elevated tHcy in GDM women.