title: Plasma homocysteine thiolactone associated with risk of macrovasculopathy in Chinese patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  This study investigated the role of homocysteine thiolactone (HcyT) in the development of macrovascular complications in Chinese patients with type 2 diabetes. HcyT has been proposed as a possible molecular basis for homocysteine (Hcy)-induced vascular damage.
  
  
  METHODS
  One hundred and sixty subjects were recruited into this study: 40 healthy controls and 120 patients with type 2 diabetes. Plasma Hcy levels were measured by polarization immunoassay and HcyT concentrations were monitored using high-performance liquid chromatography on a reversephase C18 column with ultraviolet detection. Plasma folic acid and vitamin B(12) levels were measured using radioimmunoassay methods.
  
  
  RESULTS
  Plasma Hcy and HcyT concentrations in patients with type 2 diabetes were significantly higher than in healthy controls (Hcy [25th and 75th quartiles]: 9.28 [7.51-11.82] vs. 5.64 [5.17-8.00] micromol/L, P=0.01; HcyT: 3.38 [2.94-4.73] vs. 2.91 [2.77-3.08] nmol/L, P<0.05). Plasma Hcy and HcyT levels in patients with macrovasculopathy (MAVP) were significantly higher compared with patients without MAVP (Hcy: 10.36 [7.67-12.45] vs. 7.85 [6.76-10.52] micromol/L, P<0.05; HcyT: 4.27 [3.02-5.11] vs. 3.12 [2.63-3.77] nmol/L, P<0.05). Plasma HcyT concentrations were positively correlated with urinary excretion of albumin/creatinine (Alb/Cr; r=0.285, P=0.007), duration of diabetes (r=0.249, P=0.019), age (r=0.233, P=0.028), and fibrinogen levels (r=0.289, P=0.034). Plasma HcyT concentrations were negatively correlated with high-density lipoprotein levels (r=-0.223, P=0.037). Binary logistic regression showed that HcyT, Hcy, smoking, serum triglyceride, and urine Alb/Cr were significantly associated with the risk of diabetic MAVP (P<0.05).
  
  
  CONCLUSIONS
  Hcy and HcyT levels were associated with the development and progression of diabetic MAVP. HcyT may provide a plausible chemical mechanism for explaining Hcy toxicity in the human vascular endothelium.
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Weijun
authors.initials: W
authors.lastname: Gu
authors.forename: Juming
authors.initials: J
authors.lastname: Lu
authors.forename: Guoqing
authors.initials: G
authors.lastname: Yang
authors.forename: Jingtao
authors.initials: J
authors.lastname: Dou
authors.forename: Yiming
authors.initials: Y
authors.lastname: Mu
authors.forename: Junhua
authors.initials: J
authors.lastname: Meng
authors.forename: Changyu
authors.initials: C
authors.lastname: Pan
mesh_terms: D000367:Age Factors; D044466:Asian People; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D002851:Chromatography, High Pressure Liquid; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000208:ethnology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000208:ethnology; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000031:analogs & derivatives* / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D013997:Time Factors; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D008055:Lipids; D006710:Homocysteine; D005492:Folic Acid; C007957:homocysteine thiolactone; D014805:Vitamin B 12