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Published on: May 17, 2024

Elevated homocysteine levels are associated with increased diabetes risk in patients with hypertension: a multicenter

Ya He1, Xianwei Tian2, Chenru Zhao3

  • 1Heart, Lung and Vessels Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Frontiers in Cardiovascular Medicine
|June 25, 2026
PubMed

Insights

High homocysteine (Hcy) levels in hypertensive patients significantly increase diabetes risk. Lowering Hcy may offer dual benefits for blood pressure and diabetes prevention.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Disorders

Background:

  • Homocysteine (Hcy) is linked to hypertension, but its association with diabetes is debated.
  • Investigating the Hcy-diabetes link in hypertensive individuals is crucial for understanding disease comorbidities.

Purpose of the Study:

  • To examine the relationship between homocysteine levels and the risk of developing diabetes in patients with hypertension.
  • To identify potential thresholds for homocysteine that may indicate increased diabetes risk.

Main Methods:

  • A cohort of 5,981 hypertensive patients was analyzed.
  • Multivariable Cox regression and Kaplan-Meier curves assessed diabetes risk associated with Hcy.
  • Restricted cubic spline analysis identified sex-specific Hcy thresholds for diabetes risk.

Main Results:

  • Elevated Hcy significantly correlated with increased diabetes risk (3.3% per 1 μmol/L increase).
  • The highest diabetes incidence occurred in patients with elevated Hcy levels.
  • Specific Hcy thresholds (15.2 μmol/L for females, 15.9 μmol/L for males) marked a sharp rise in diabetes risk.

Conclusions:

  • Elevated homocysteine is a significant predictor of future diabetes in hypertensive patients.
  • Hcy levels exceeding identified thresholds indicate a markedly higher risk.
  • Reducing Hcy may provide a dual benefit, aiding both blood pressure management and diabetes prevention.
Abstract

Keywords:
cardiovascular diseasediabeteshomocysteinehypertensioninsulin resistance

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