title: Influence of diabetes on homocysteine-lowering therapy in chronic hemodialysis patients.
abstract: BACKGROUND
  The effect of homocysteine (Hcy)-lowering therapy may be different in hemodialysis (HD) patients with and without diabetes mellitus (DM).
  
  
  METHODS
  Stable HD patients with uremia were administered folic acid and vitamin B for 3 months. The impact of treatment was compared in patients with and without DM.
  
  
  RESULTS
  A total of 61 patients (31 men and 30 women) aged 56 ± 13 y completed the study. Among these, 44 patients (72%) did not have DM and 17 (28%) had DM. At baseline, total Hcy and high-sensitivity C-reactive protein (hsCRP) levels were similar. After treatment, the levels of total Hcy and hsCRP were significantly decreased in the nondiabetic group (total Hcy level decreased from 33.63 ± 14.13 μmol/l to 18.94 ± 8.46 μmol/l, p<0.001; hsCRP level decreased from 0.58 mg/dl [range, 0.21-1.05 mg/dl] to 0.22 mg/dl [range, 0.11-0.53 mg/dl], p<0.001) but not in the diabetic group (total Hcy level decreased from 34.97 ± 17.12 μmol/l to 29.53 ± 11.36 μmol/l, p=0.057; hsCRP level decreased from 0.80 mg/dl [range, 0.24-1.47 mg/dl] to 0.49 mg/dl [range, 0.45-0.98 mg/dl], p=0.28). Serial monitoring of total Hcy level showed a more sustained effect of therapy on patients without DM.
  
  
  CONCLUSIONS
  Folic acid and vitamin B administration significantly lower total Hcy and hsCRP levels in HD patients without DM but not in those with DM.
authors: Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
authors: Kuo-Cheng
authors: KC
authors: Lu
authors: Wen-Ya
authors: WY
authors: Ma
authors: Chun-Chi
authors: CC
authors: Chen
authors: Kuo-Chin
authors: KC
authors: Hung
authors: Hsiao-Shuang
authors: HS
authors: Chen
authors: Chia-Chao
authors: CC
authors: Wu
authors: Tzu-Yuan
authors: TY
authors: Chang
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D048909:Diabetes Complications / Q000097:blood* / Q000188:drug therapy / Q000628:therapy*; D019587:Dietary Supplements; D005492:Folic Acid / Q000494:pharmacology / Q000627:therapeutic use; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D006435:Renal Dialysis; D014511:Uremia / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D014805:Vitamin B 12 / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein; D005492:Folic Acid; D014805:Vitamin B 12