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Type 1 diabetes mellitus and homocyst(e)ine
J F Robillon1, B Canivet, M Candito
1Department of Internal Medicine, Endocrinology and Metabolism, Centre Hospitalier Universitaire, Nice, France.
Insights
High homocysteine levels, a risk factor for atherosclerosis, were found to be lower in type 1 diabetic subjects compared to controls. This study suggests homocysteine may not directly explain accelerated atherosclerosis in diabetes mellitus.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Research
- Clinical Chemistry
Background:
- High homocysteine levels are a recognized risk factor for atherosclerosis.
- Patients with diabetes mellitus (DM) exhibit increased susceptibility to atherosclerosis.
- The relationship between DM, homocysteine levels, and atherosclerosis risk requires further investigation.
Purpose of the Study:
- To investigate the effect of type 1 diabetes mellitus on homocysteine levels.
- To explore the relationship between homocysteine and other metabolic parameters in diabetic subjects.
- To determine if homocysteine levels contribute to accelerated atherosclerosis in diabetes.
Main Methods:
- Comparison of homocysteine levels and associated biochemical parameters between 41 type 1 diabetic subjects and 40 age-matched controls.
- Measurement of homocysteine via ion-exchange chromatography.
- Assessment of parameters including lipids, vitamins B9/B12, renal and retinal status, and HbA1c.
Main Results:
- Significantly lower homocysteine levels were observed in diabetic subjects (6.8 +/- 2.2 mumol/l) compared to controls (9.5 +/- 2.9 mumol/l) (p = 0.0001).
- This difference persisted across male and female subgroups.
- No correlation was found between homocysteine and lipids, vitamins, or renal/retinal status; however, homocysteine showed a slight increase with age, particularly in women.
Conclusions:
- Type 1 diabetes mellitus is associated with lower homocysteine levels compared to healthy individuals.
- Current findings suggest homocysteine may not be a direct factor in the accelerated atherosclerosis observed in diabetes mellitus.
- Further research is needed to ascertain if specific homocysteine levels identify diabetic subgroups at higher risk for premature or severe atherosclerosis.
Abstract:
High Homocyst(e)ine levels (H) have been recently recognized as a risk factor for atherosclerosis. Patients with Diabetes Mellitus (DM) are prone to atherosclerosis. Therefore, this study was designed to search for the effect of DM on H and their relationship. Forty-one Type 1 diabetic subjects (DS, age 34.8 +/- 12 yr, DM duration: 10.7 +/- 11.1 yr) were compared to 40 age-matched control subject (CS, age 34.2 +/- 9.1 yr). H (measured by ion-exchange chromatography, units: mumol/l) and several parameters (creatininemia; triglycerides; total, HDL, LDL cholesterol; Lp(a); HbA1c; vitamins B9 and B12) were determined after an overnight fast. H were significantly (p = 0.0001) lower in DS (6.8 +/- 2.2) than in CS (9.5 +/- 2.9). This difference was still apparent in male and female subgroups compared to matched CS (p = 0.003 for each). No correlation was found between H and: lipids, vitamins, renal or retinal status. But H seemed to increase with age, especially in women (p = 0.03; r = 0.32). While there is, at this time, no explanation for the lower H observed in DS, it appears that H cannot directly account for accelerated atherosclerosis in DM. Nevertheless, it remains to be established if high, or even normal, H could identify a subgroup of DS at higher risk of precocious and severe atherosclerosis.