The effect of homocysteine levels on microalbuminuria and retinopathy in type 2 diabetes mellitus [Tip 2 diabetes mellituslu hastalarda homosistein düzeylerinin mikroalbuminüri ve retinopati üzerine etkisi]

Abstract

Objective: Micro-and macrovascular complications are the most important cause of morbidity and mortality in diabetic patients. The risk of vascular disease in diabetes is associated with hyperglycaemia and other risk factors such as hyperlipidaemia, hypertension and obesity. Several studies indicated that increase in total plasma homocystein levels were associated with micro-macrovascular disease in diabetic patients. However, the role of hyperhomocysteinemia in the development of type 2 diabetic retinopathy and microalbuminuria are still unknown. In this study, our aim was to determine the relationship between the fasting plasma homocysteine levels and the presence of diabetic retinopathy and microalbuminuria in patients with type 2 diabetes. Material and Methods: A total of 70 patients (24 men, 46 women; aged 35-80 years) followed in Cumhuriyet University Faculty of Medicine, Department of Internal Medicine between June 2004 and November 2004 were enrolled in the study. Twenty healthy individuals of the same age and gender formed the control group and was named group 1. The diabetic population was classified in 4 groups with regard to microalbuminuria and retinopathy complications. Group 2 consisted of 20 diabetic patients without microalbuminuria and rethinopathy complications, group 3 consisted of 20 diabetic patients with microalbuminuria and without rethinopathy complications, group 4 consisted of 10 diabetic patients with rethinopathy and without microalbuminuria complications, and group 5 consisted of 20 diabetic patients with microalbuminuria and rethinopathy complications. Venous blood was obtained between 07.00 a.m and 10.00 a.m after an overnight fast. Homocysteine levels of control and study groups were measured. Results: The homocysteine levels were 7.66 ± 1.98 ?mol/L in the control group, 9.65 ± 3.42 ?mol/L in the second group, 10.97 ± 3.71 ?mol/L in the third group, 15.06 ± 9.34 ?mol/L in the fourth group and 14.71 ± 5.33 ?mol/L in the fifth group. Conclusion: While plasma homocysteine levels were significantly higher in group 4 and 5 in type 2 diabetic patients (p= 0.001), in group 3 homocysteine levels were higher than in the control group and group 2, but this difference was not statistically significant (p= 0.5). Copyright © 2006 by Türkiye Klinikleri.