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Total plasma homocysteine is associated with hypertension in Type I diabetic patients

S Neugebauer1, L Tarnow, C Stehouwer

  • 1Third Department of Internal Medicine, Fukushima Medical University, Hikarigaoka 1, 960-1295 Fukushima, Japan. sneugeba@fmu.ac.jp

Diabetologia
|September 21, 2002
PubMed

Insights

Elevated plasma homocysteine, not MTHFR gene variants, increases hypertension and coronary heart disease risk in Type I diabetic patients with normal kidney function.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Genetics

Background:

  • Hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism are implicated in cardiovascular disease (CVD).
  • Their specific roles in diabetic microangiopathy and hypertension remain debated.
  • This study investigates these factors in relation to vascular complications and kidney function in Type I diabetes.

Purpose of the Study:

  • To explore the association between plasma homocysteine levels, MTHFR gene polymorphism, and vascular complications in Type I diabetic patients.
  • To determine the relationship between these factors and hypertension and kidney function.

Main Methods:

  • Investigated vascular complications, hypertension, MTHFR genotype (RFLP), and plasma homocysteine (HPLC) in 389 Type I diabetic patients.
  • Patients were stratified by normal (GFR ≥75 ml/min/1.73 m²) and impaired renal function (GFR <75 ml/min/1.73 m²).

Main Results:

  • Higher plasma homocysteine was observed in patients with vascular complications.
  • After adjusting for GFR, homocysteine >8.6 µmol/l was linked to hypertension (OR 1.9-3.7) and homocysteine >11.3 µmol/l to coronary heart disease (OR 5.9) in patients with normal GFR.
  • MTHFR gene polymorphism (T allele) independently determined homocysteine levels but was not associated with complications or hypertension.

Conclusions:

  • Increased plasma homocysteine concentrations, independent of MTHFR gene variants, elevate the risk of hypertension and coronary heart disease.
  • These findings are significant for Type I diabetic patients with preserved renal function.
Abstract

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