title: Circulating homocysteine levels in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Previous studies have shown conflicting results regarding circulating homocysteine levels in patients with type 2 diabetes.
  
  
  RESULTS
  This observational study included 2121 patients with angiographically proven coronary artery disease (507 patients with type 2 diabetes and 1614 patients without diabetes). Circulating homocysteine levels, methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, renal function, presence of coronary artery disease (CAD) diagnosed by coronary angiography, and circulating folate and vitamin B12 status were assessed. Plasma homocysteine levels [median (25th; 75th percentile)] were significantly higher in patients with diabetes than in those without [12.4 micromol/L (9.9 micromol/L; 15.9 micromol/L) versus 11.7 micromol/L (9.6 micromol/L; 14.5 micromol/L), P=0.011]. Diabetes affected homocysteine levels only in patients with a glomerular filtration rate <90 mL/min [13.0 micromol/L (10.5 micromol/L; 16.7 micromol/L) in patients with diabetes versus 12.2 micromol/L (10.1 micromol/L; 15.2 micromol/L) in patients without diabetes, P=0.006] but not in those with a glomerular filtration rate > or = 90 mL/min [10.1 micromol/L (8.1 micromol/L; 12.4 micromol/L) versus 10.2 micromol/L (8.8 micromol/L; 12.3 micromol/L), P=0.267]. Multivariable analysis did not show an independent association between diabetes and homocysteine level (P=0.342).
  
  
  CONCLUSIONS
  Circulating homocysteine levels are increased in patients with type 2 diabetes compared with non-diabetic patients due to a more diabetes-associated adverse risk profile rather than to diabetes itself.
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Lazarettstrasse 36, 80636 Munich, Germany. ndrepepa@dhm.mhn.de
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Siegmund
authors.initials: S
authors.lastname: Braun
authors.forename: Werner
authors.initials: W
authors.lastname: Koch
authors.forename: Klaus
authors.initials: K
authors.lastname: Kölling
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology / Q000235:genetics / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics / Q000503:physiopathology; D005260:Female; D005492:Folic Acid / Q000097:blood; D005838:Genotype; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D016014:Linear Models; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D008875:Middle Aged; D015999:Multivariate Analysis; D011110:Polymorphism, Genetic; D015854:Up-Regulation; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D001786:Blood Glucose; D005492:Folic Acid; D006442:Glycated Hemoglobin; D006710:Homocysteine; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D014805:Vitamin B 12; C517652:hemoglobin A1c protein, human