[The impact of plasma homocysteine level on development of retinopathy in type 2 diabetes mellitus].
OBJECTIVE
An increased plasma homocysteine level is an important risk factor for vascular disease in the general population. However, the role of hyperhomocysteinemia in the development of type 2 diabetic retinopathy (DR) is still unknown. Therefore, our aim was to determine the relationship between the fasting plasma homocysteine (Hcy) levels and the presence of diabetic retinopathy in patients with type 2 diabetes.


METHODS
The study group consisted of 55 cases of type 2 diabetic patients (DM); 19 healthy persons served as control (CON, 12 men and 7 women). The DM group were subdivided into a group without diabetic complications (NDC, 39 cases, 17 men and 22 women) and a group with DR (16 cases, 8 men and 8 women). The renal function and the ratio of albumin/creatinine (Alb/Cr) were within normal range in all the subjects. The presence and the grade of retinopathy were determined by an ophthalmologist. Plasma total Hcy (tHcy) was measured by automated high-performance liquid chromatography (HPLC) with reverse phase separation and fluorescence detection.


RESULTS
Plasma tHcy levels were significantly different among DR, NDC and CON groups (F = 2.405, P = 0.031). Plasma total Hcy was significantly higher in DR group [(14.7 +/- 5.28) micromol/L] than in NDC [(11.3 +/- 4.94) micromol/L] and CON group [(9.65 +/- 2.66) micromol/L]. There was no difference between NDC group and CON group. In DR group, plasma tHcy was significantly higher in proliferative diabetic retinopathy (PDR) group than that in background diabetic retinopathy (BDR) group (t = 2.405, P = 0.031). Hyperhomocysteinemia was defined as tHcy level > 14.97 micromol/L and was seen in 4 patients in PDR group, the rate being significantly higher than that in BDR group.


CONCLUSIONS
It is suggested that hyperhomocysteinemia may be a risk factor for the development and progression of type 2 diabetic retinopathy.
Yang
Guoqing
G
Department of Endocrinology, General Hospital of the PLA, Beijing 100853, China. yanggq@public.bta.net.cn
Lu
Juming
J
Pan
Changyu
C
D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003930:Diabetic Retinopathy / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index
D006710:Homocysteine