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Hyperhomocyst(e)inemia and endothelial dysfunction in IDDM

M A Hofmann1, B Kohl, M S Zumbach

  • 1Department of Medicine, University of Heidelberg, Germany.

Diabetes Care
|December 24, 1997
PubMed
Summary
This summary is machine-generated.

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Elevated homocysteine levels are common in patients with type 1 diabetes and are linked to microvascular complications. This may contribute to increased cardiovascular disease risk in diabetic patients with nephropathy.

Area of Science:

  • Endocrinology
  • Vascular Biology
  • Metabolic Diseases

Background:

  • Elevated blood homocysteine is an independent risk factor for macrovascular disease.
  • Diabetic microvascular complications are a major cause of morbidity and mortality.

Purpose of the Study:

  • To assess the link between hyperhomocysteinemia and diabetic microvascular diseases.
  • To investigate the role of endothelial cell damage markers in this association.

Main Methods:

  • Measured plasma homocysteine and thrombomodulin (TM) levels in 75 patients with insulin-dependent diabetes mellitus (IDDM) and 40 healthy controls.
  • Assessed levels before and after oral methionine loading, excluding participants with hyperlipidemia, hypertension, smoking, or family history of cardiovascular disease.

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Main Results:

  • IDDM patients exhibited significantly higher pre- and postload homocysteine levels than controls.
  • IDDM patients with hyperhomocysteinemia showed elevated TM levels, increased albumin excretion rates, and a higher prevalence of diabetic complications (nephropathy, retinopathy, neuropathy, macroangiopathy).
  • In vitro studies indicated a synergistic effect of homocysteine and advanced glycation end products (AGEs) on endothelial cell damage.

Conclusions:

  • Hyperhomocysteinemia is prevalent in diabetic patients with nephropathy.
  • It may contribute to the increased cardiovascular disease risk and mortality observed in IDDM patients, particularly those with diabetic nephropathy.