Plasmatic homocysteine concentration and its relationship with complications associated to diabetes mellitus

Background and methods: In the search for new factors of cardiovascular risk associated to diabetes mellitus (DM), special attention has been paid in recent years to hyperhomocysteinaemia. Therefore, we have established the concentration of homocysteine (Hcy) and other biochemical parameters in the plasma of a group of 57 type I and 32 type 2 diabetic patients and 54 control subjects and studied whether plasmatic homocysteinaemia was related to rnacroangiopathy, nephropathy, retinopathy and neuropathy. Because of significant differences for plasma Hcy values between men and women in the control group, we distinguished between both groups throughout the study. Results: Patients with DM had higher Hcy than control subjects (11.7 +/- 5.4 vs. 10.1 +/- 2.4 mumol/l, p < 0.05). Fasting hyperhomocysteinaemia was considered as the mean of the plasma Hcy for control subjects + 2 SD (14.9 mumol/l in total group, 15.6 mumol/l in males and 13.9 mumol/l in females). In the studied groups with complications, we found significant differences between normohomocysteinaemic type I diabetic patients and those considered hyperhomocysteinaemic by us. On the other hand, patients having type I DM and complications had higher plasmatic Hcy concentration than those with no complications. Conclusions: We have found a relationship between high Hey levels and prevalence of macroangiopathy, retinopathy and nephropathy in the type I diabetic patients, which was not been observed in the type 2 diabetic patients of our study. As a result, we consider plasmatic Hey a complication-risk indicator in type I DM, and we recommend its use together with already established biochemical parameters in the control of the evolution of the disease. (C) 2002 Elsevier Science B.V. All rights reserved.