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[Chronic complication of diabetes and homocysteine]
1Katedra Chorób Metabolicznych Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Insights
High homocysteine levels increase cardiovascular disease risk, especially in diabetics. Further research is needed to clarify its role in diabetic microvascular complications for better prevention strategies.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Metabolic Diseases
Context:
- Elevated homocysteine is linked to cardiovascular disease (CVD) incidence and mortality.
- Diabetics with hyperhomocysteinemia face even greater CVD risks.
- Mechanisms include procoagulant activity, oxidative stress, and smooth muscle cell proliferation.
Purpose:
- To investigate the role of hyperhomocysteinemia in microvascular complications of diabetes.
- To explore the relationship between homocysteine levels and diabetic retinopathy, neuropathy, and albuminuria.
- To assess the potential for modifying homocysteine levels in diabetes prevention and management.
Summary:
- Hyperhomocysteinemia is a risk factor for cardiovascular disease, particularly in individuals with diabetes mellitus.
- While its role in macrovascular complications is established, its impact on microvascular complications like retinopathy, neuropathy, and albuminuria is debated.
- Homocysteine levels are influenced by age, renal function, and B vitamin/folic acid intake, with insulin's role also under investigation.
Impact:
- Clarifying hyperhomocysteinemia's role in microvascular complications can guide preventative strategies.
- Understanding these mechanisms may lead to novel dietary and pharmacological interventions for diabetes management.
- This research could improve prevention of both macrovascular and microvascular complications in diabetic patients.
Abstract:
Increased homocysteine levels are associated with increased risk of cardiovascular disease incidence and mortality in general population and with even greater risk in persons with diabetes mellitus. Among possible mechanisms of proatherogenic action of homocysteine increased procoagulant activity, increased oxidative stress and effect on proliferation of smooth muscle cells should be mentioned. However, the role of hyperhomocysteinemia in the development of microvascular complications is the subject of a few studies with controversial results. Some studies indicate the role of hyperhomocysteinemia in predicting micro- and macroalbuminuria and also retinopathy and neuropathy. Serum homocystine levels are dependent on age, renal function, and dietary intake of folic acid and B vitamins. The role of insulin in homocysteine metabolism is the subject of studies. Determination of the role of hyperhomocysteinemia in macrovascular and microvascular diabetes complications could be of importance in their prevention through dietary and pharmacological modifications of homocysteine levels.