title: Plasma total homocysteine and carotid intima-media thickness in type 1 diabetes: a prospective study.
abstract: OBJECTIVE
  Plasma total homocysteine (tHcy) has been positively associated with carotid intima-media thickness (IMT) in non-diabetic populations and in a few cross-sectional studies of diabetic patients. We investigated cross-sectional and prospective associations of a single measure of tHcy with common and internal carotid IMT over a 6-year period in type 1 diabetes.
  
  
  METHODS
  tHcy levels were measured once, in plasma obtained in 1997-1999 from patients (n = 599) in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, the observational follow-up of the Diabetes Control and Complications Trial (DCCT). Common and internal carotid IMT were determined twice, in EDIC "Year 6" (1998-2000) and "Year 12" (2004-2006), using B-mode ultra-sonography.
  
  
  RESULTS
  After adjustment, plasma tHcy [median (interquartile range): 6.2 (5.1, 7.5) μmol/L] was significantly correlated with age, diastolic blood pressure, renal dysfunction, and smoking (all p < 0.05). In an unadjusted model only, increasing quartiles of tHcy correlated with common and internal carotid IMT, again at both EDIC time-points (p < 0.01). However, multivariate logistic regression revealed no significant associations between increasing quartiles of tHcy and the 6-year change in common and internal carotid IMT (highest vs. lowest quintile) when adjusted for conventional risk factors.
  
  
  CONCLUSIONS
  In a type 1 diabetes cohort from the EDIC study, plasma tHcy measured in samples drawn in 1997-1999 was associated with measures of common and internal carotid IMT measured both one and seven years later, but not with IMT progression between the two time-points. The data do not support routine measurement of tHcy in people with Type 1 diabetes.
authors: Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma.
authors: Arpita
authors: A
authors: Basu
authors: University of Sydney, NHMRC Clinical Trials Centre, Camperdown, Sydney, NSW, Australia.|Centre for Experimental Medicine, Queen's University of Belfast, N. Ireland, UK.
authors: Alicia J
authors: AJ
authors: Jenkins
authors: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
authors: Julie A
authors: JA
authors: Stoner
authors: Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina.
authors: Suzanne R
authors: SR
authors: Thorpe
authors: Division of Endocrinology, Medical University of South Carolina, Charleston, South Carolina.|The Ralph H Johnson Veterans Affairs Medical Center, Charleston, South Carolina.
authors: Richard L
authors: RL
authors: Klein
authors: Division of Endocrinology, Medical University of South Carolina, Charleston, South Carolina.|The Ralph H Johnson Veterans Affairs Medical Center, Charleston, South Carolina.
authors: Maria F
authors: MF
authors: Lopes-Virella
authors: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
authors: W Timothy
authors: WT
authors: Garvey
authors: Centre for Experimental Medicine, Queen's University of Belfast, N. Ireland, UK.|Section of Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
authors: Timothy J
authors: TJ
authors: Lyons
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology / Q000473:pathology; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008055:Lipids; D006710:Homocysteine; D002097:C-Reactive Protein
keywords: homocysteine; intima-media thickness; type 1 diabetes