title: Homocysteine, cysteine, folate and vitamin B₁₂ status in type 2 diabetic patients with chronic kidney disease.
abstract: BACKGROUND
  Hyperhomocysteinemia (hHcy) is a risk factor in the progression of chronic kidney disease (CKD). In type 2 diabetes (T2D), hHcy is strongly associated with increased risk of cardiovascular disease. Vitamin B12 and folic acid supplementation have been reported to lower homocysteine (tHcy) levels, but no data on plasma tHcy, cysteine (Cys), folate and vitamin B12 levels in T2D-CKD patients are reported.
  
  
  METHODS
  tHcy and Cys levels were analyzed in 178 T2D-CKD patients by high performance liquid chromatography (HPLC) with fluorescence detection. In addition, we determined folate and vitamin B12 levels using a chemiluminescence method.
  
  
  RESULTS
  tHcy and Cys levels were increased in T2D patients, and this rise positively correlated with the CKD stage (P < 0.001). Folate levels were comparable to controls at various CKD stages, whereas vitamin B12 levels were lower, except at stage IV. We did not find any correlation between B-vitamins and levels of tHcy and Cys, regardless of the CKD stage.
  
  
  CONCLUSIONS
  This is the first study reporting tHcy, Cys and B-vitamins status in T2D-CKD patients. Although limited to our cohort of 178 patients, our findings could be helpful in clarifying the conflicting literature regarding B-vitamins supplementation. Further studies are necessary before any Hcy-lowering therapy can be safely established in T2D-CKD subjects.
authors.affiliation: Metabolomic and Proteomic Unit, Children's Hospital "Bambino Gesù", IRCCS, P.zza S. Onofrio, 4, 00165, Rome, Italy. anna.pastore@opbg.net.
authors.forename: Anna
authors.initials: A
authors.lastname: Pastore
authors.affiliation: Department of Internal Medicine, Nephrology and Hypertension Unit, "Tor Vergata" University Hospital, Rome, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Noce
authors.affiliation: Metabolomic and Proteomic Unit, Children's Hospital "Bambino Gesù", IRCCS, P.zza S. Onofrio, 4, 00165, Rome, Italy.
authors.forename: Gianna
authors.initials: G
authors.lastname: Di Giovamberardino
authors.affiliation: Department of Laboratory Medicine, "Tor Vergata" University Hospital, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Stefano
authors.affiliation: Department of Laboratory Medicine, "Policlinico Gemelli" University Hospital, Rome, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Callà
authors.affiliation: Department of Laboratory Medicine, "Tor Vergata" University Hospital, Rome, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Zenobi
authors.affiliation: Department of Laboratory Medicine, "Tor Vergata" University Hospital, Rome, Italy.
authors.forename: Mariarita
authors.initials: M
authors.lastname: Dessì
authors.affiliation: Department of Internal Medicine, Nephrology and Hypertension Unit, "Tor Vergata" University Hospital, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Daniele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003545:Cysteine / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D018450:Disease Progression; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid; D003545:Cysteine; D014805:Vitamin B 12
keywords: Chronic kidney disease; Cysteine; Folate; Homocysteine; Type 2 diabetes; Vitamin B12
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