title: Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study.
abstract: The aim of the present study was to investigate the relationship between homocysteine and homocysteine metabolism components and retinal microvascular disorders in subjects with and without Type 2 diabetes. In this population-based study of 256 participants, aged 60-85 years, we determined total plasma homocysteine, SAM (S-adenosylmethionine) and SAH (S-adenosylhomocysteine) in plasma and erythrocytes, total folate in serum and erythrocytes, 5-MTHF (5-methyltetrahydrofolate), and vitamins B12 and B6. Participants were examined ophthalmologically by means of indirect funduscopy and two-field 45 degrees fundus photography, and were graded for retinopathy and retinal sclerotic vessel abnormalities. A computer-assisted method was used to measure retinal vessel diameters. Total plasma homocysteine was inversely associated with retinal arteriolar diameters {standardized beta, -0.20 [95% CI (confidence interval), -0.33 to -0.07]} or a decrease of 3.78 microm CRAEs (central retinal arteriolar equivalents) per 1 S.D. increase in homocysteine level (=4.6 micromol/l). In addition, the SAM/SAH ratio in plasma was inversely associated with retinal sclerotic vessel abnormalities and retinopathy [odds ratios, 0.61 (95% CI, 0.39-0.96) and 0.50 (95% CI, 0.30-0.83) per 1 S.D. respectively]. The associations were independent of age, sex, glucose tolerance status, other homocysteine metabolism components and cardiovascular risk factors. In conclusion, the results of the present study support the concept that total plasma homocysteine and a low SAM/SAH ratio in plasma, which may reflect reduced transmethylation reactions, may contribute to the pathogenesis of (retinal) microangiopathy.
authors.affiliation: Department of Ophthalmology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands. m.vanhecke@vumc.nl
authors.forename: Manon V
authors.initials: MV
authors.lastname: Van Hecke
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Tom
authors.initials: T
authors.lastname: Teerlink
authors.forename: Cornelis
authors.initials: C
authors.lastname: Jakobs
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Stolk
authors.forename: Rob J
authors.initials: RJ
authors.lastname: Heine
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Bettine C P
authors.initials: BC
authors.lastname: Polak
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000473:pathology; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000473:pathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000473:pathology; D005260:Female; D005492:Folic Acid / Q000097:blood; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000378:metabolism* / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology; D012435:S-Adenosylhomocysteine / Q000097:blood; D012436:S-Adenosylmethionine / Q000097:blood
chemical_list: D001786:Blood Glucose; D006710:Homocysteine; D012436:S-Adenosylmethionine; D005492:Folic Acid; D012435:S-Adenosylhomocysteine