Relation of plasma homocysteine levels to atherosclerotic vascular disease and inflammation markers in type 2 diabetic patients.
OBJECTIVE
Both hyperhomocysteinemia and increased inflammatory activity are shown to be associated with atherosclerosis. The relation of inflammatory activity to homocysteine (Hcy) levels is not well established. In the present study, we aimed to evaluate the relation of plasma Hcy levels to atherosclerotic vascular disease and inflammatory activity in type 2 diabetic patients.


METHODS
In total 90 type 2 diabetic patients were included in the study. Of these patients, 41 had established atherosclerotic vascular disease and 49 had no evidence of atherosclerotic vascular disease. Hcy levels and markers of inflammation, namely C-reactive protein, fibrinogen, erythrocyte sedimentation rate, interleukin-6, and tumor necrosis factor alpha (TNFalpha), were measured. Glucose regulation, C-peptide, lipid parameters, and renal functions were also studied.


RESULTS
Both Hcy levels and inflammation markers were all significantly elevated in patients with atherosclerotic vascular disease when compared with patients without vascular disease. Reduced renal functions were responsible for the majority of Hcy elevation in patients with vascular disease. Also, renal functions were significantly associated with both Hcy levels and inflammatory markers. There was no correlation between Hcy levels and inflammation markers except for TNFalpha.


CONCLUSIONS
Inflammatory activity and Hcy levels are increased in type 2 diabetic patients with atherosclerotic vascular disease. Impairment of renal functions is the key factor that affects both Hcy levels and inflammation markers. Inflammation is not involved in the process by which Hcy leads atherosclerosis in type 2 diabetes.
Akalin
Aysen
A
Department of Endocrinology, Faculty of Medicine, 26480 Eskisehir Osmangazi University, Eskisehir, Turkey. aakalin@superonline.com
Alatas
Ozkan
O
Colak
Omer
O
D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications / Q000473:pathology; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005340:Fibrinogen / Q000378:metabolism; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000473:pathology; D015850:Interleukin-6 / Q000097:blood; D007677:Kidney Function Tests; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D006710:Homocysteine; D005340:Fibrinogen; D002097:C-Reactive Protein