title: Relation of homocysteine to early nephropathy in patients with Type 2 diabetes.
abstract: OBJECTIVE
  To explore the relationship between plasma total homocysteine concentration and diabetic nephropathy in patients with Type 2 diabetes.
  
  
  METHODS
  Chinese patients with Type 2 diabetes (n = 183) were enrolled in a cross-sectional hospital based study. Early diabetic nephropathy status was documented by presence of microalbuminuria. Plasma total homocysteine concentration was measured using fluorescence polarization immunoassay. Traditional risk factors for diabetic nephropathy were obtained from fasting blood samples and interviewer- questionnaire.
  
  
  RESULTS
  Plasma total homocysteine levels were higher in subjects with early diabetic nephropathy than without (13.3 ± 2.9) μmol/l vs. (8.5 ± 1.4) μmol/l, p < 0.01). The association of homocysteine with the diabetic nephropathy was independent of major traditional risk factors for diabetic nephropathy (duration of diabetes, HbA1c, and blood pressure) and determinants of higher homocysteine concentration (age, gender, serum folate and vitamin B12, serum cystatin and creatinine levels, and Biguanide use) (OR: 1.37 (0.89 - 2.24), p < 0.05). Furthermore, per increase of 4.0 μmol/l plasma homocysteine was related to nephropathy, after controlling for per unit increase of other factors (OR: 1.15 (0.94 - 1.29), p < 0.05).
  
  
  CONCLUSIONS
  Plasma total homocysteine concentration was independently associated with occurrence of early diabetic nephropathy in Chinese patients. Future prospective studies are warranted to clarify the relationship.
authors.affiliation: Endocrinology and Metabolism Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Li
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.forename: Hongman
authors.initials: H
authors.lastname: Zhang
authors.forename: Lingfei
authors.initials: L
authors.lastname: Yan
authors.forename: Ming
authors.initials: M
authors.lastname: Xie
authors.forename: Lei
authors.initials: L
authors.lastname: Zhuang
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhu
authors.forename: Jiawei
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000652:urine; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D006710:Homocysteine