title: Vitamin status as a determinant of serum homocysteine concentration in type 2 diabetic retinopathy.
abstract: We investigated the association of serum homocysteine levels and vitamin status with type 2 diabetic retinopathy. This study included 65 patients with and 75 patients without diabetic retinopathy. Patients with diabetic retinopathy had significantly higher serum homocysteine levels (P < 0.001), higher prevalence of hyperhomocysteinemia (P < 0.001), lower serum folic acid (P < 0.001), and vitamin B12 (P = 0.014) levels than those without diabetic retinopathy. Regression analysis revealed that homocysteine was an independent risk factor for diabetic retinopathy and there was a threshold in its serum level (13.7  μ mol/L), above which the risk of diabetic retinopathy greatly increases (OR = 1.66, P = 0.001). Folic acid was associated with decreased odds for diabetic retinopathy (OR = 0.73, P < 0.001). There was a threshold in serum vitamin B12 level (248.4 pg/mL), below which serum homocysteine concentration significantly increases with decreasing serum vitamin B12 (P = 0.003). Our findings suggest that hyperhomocysteinemia is an independent risk factor for the development and progression of diabetic retinopathy. Decreased serum levels of folic acid and vitamin B12, through raising serum homocysteine concentrations, may also affect the diabetic retinopathy risk.
authors.affiliation: 2nd Department of Ophthalmology, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece.
authors.forename: Pandelis
authors.identifier: 0000-0003-0200-3777
authors.initials: P
authors.lastname: Fotiou
authors.affiliation: 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Raptis
authors.affiliation: Department of Molecular Diagnosis, "Hippokration" General Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Apergis
authors.affiliation: 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Dimitriadis
authors.affiliation: Athens Eye Hospital, 45 Vouliagmenis Avenue, 16675 Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vergados
authors.affiliation: 2nd Department of Ophthalmology, "Attikon" University Hospital, Athens University Medical School, 1 Rimini Street, 12462 Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Theodossiadis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003930:Diabetic Retinopathy / Q000097:blood*; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood; D014815:Vitamins / Q000097:blood*
chemical_list: D014815:Vitamins; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12