HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ozmen, B. Articles by Bayindir, O. Search for Related Content PubMed PubMed Citation Articles by Ozmen, B. Articles by Bayindir, O.

Association Between Homocysteinemia and Renal Function in Patients with Type 2 Diabetes Mellitus

Address correspondence to Dilek Ozmen, M.D., Department of Clinical Biochemistry, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey; tel and fax 90 232 339 2144; email: dozmen{at}med.ege.edu.tr.

Homocysteinemia is an independent risk factor for cardiovascular disease, but information on its association with type 2 diabetes and mild renal dysfunction is limited. Plasma total homocysteine (tHcy) concentration is partly determined by renal plasma clearance. Serum cystatin C (Cys C) concentration has been introduced as a marker of renal function, specifically as an indicator of glomerular filtration rate (GFR). The aim of this study was to explore the relationships among tHcy, creatinine clearance (Ccr), serum Cys C, and microalbuminuria in a population with type 2 diabetes. Fasting plasma tHcy, serum homocysteine-related vitamins (folate and vitamin B₁₂), serum Cys C, serum creatinine, urine microalbumin, and creatinine clearance were determined in 75 type 2 diabetic patients and 40 healthy control subjects. The patients were assigned to two groups based on urinary albumin excretion (UAE): normoalbuminuric (NAU, UAE <30 mg/24 hr, n = 35) and microalbuminuric (MAU, UAE 30–300 mg/24 hr, n = 40). Ccr was calculated using the Cockroft-Gault formula. Plasma Hcy levels were determined by HPLC with fluorescence detection and serum Cys C by automated particle enhanced immunoturbidimetry. Plasma tHcy levels were significantly higher in normoalbuminuric and microalbuminuric patients than in controls (10.64 ± 0.53, 13.29 ± 0.78, 6.91 ± 0.37 mmol/L, respectively). Serum Cys C levels in microalbuminuric diabetics were higher than in normoalbuminurics and controls (1.36 ± 0.06, 1.12 ± 0.04, 1.10 ± 0.06 mg/L, respectively). Positive correlations were noted between tHcy and Cys C levels in normoalbuminuric and microalbuminuric diabetics (r = 0.72, r = 0.64, respectively ). Homocysteine and creatinine concentrations were correlated in both diabetic groups (r = 0.89, r = 0.93, NAU and MAU, respectively ). Elevated plasma total homocysteine concentrations in type 2 diabetics suggest an association between homocysteinemia and deterioration of renal function, evidenced by increased serum creatinine and Cys C, Ccr, and microalbuminuria. These findings implicate homocysteinemia in the relationship between diabetic nephropathy and cardiovascular complications of diabetes.

Keywords: diabetes mellitus type 2, homocysteine, cystatin C, microalbuminuria, renal function

This article has been cited by other articles:

				S Patterson, P R Flatt, L Brennan, P Newsholme, and N H McClenaghan Detrimental actions of metabolic syndrome risk factor, homocysteine, on pancreatic {beta}-cell glucose metabolism and insulin secretion. J. Endocrinol., May 1, 2006; 189(2): 301 - 310. [Abstract] [Full Text] [PDF]

				M.-C. Beauvieux, V. Rigalleau, C. Perlemoine, L. Baillet, and H. Gin Homocysteinemia Is Not Changed by 3-Day Insulin-Induced Normoglycemia in Type 2 Diabetic Subjects Diabetes Care, August 1, 2003; 26(8): 2475 - 2476. [Full Text] [PDF]