title: [Plasma homocysteine, Lp(a), and oxidative stress markers in peripheral macroangiopathy in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  To study new risk factors for peripheral macroangiopathy (PM) in patients with diabetes, as oxidative stress (OS) and its interaction with classical risk factors: age, Lp(a), plasma homocysteine values and HbA1c.
  
  
  METHODS
  We studied 204 type2 diabetic (T2DM) patients, consecutive selected form a reference hospital and a secondary hospital form our Community (2009-2010). Design was a case (ABI<0.89) control (ABI0.9-1.2) study. PM was defined using ankle brachial index (ABI). Thirty nine T2DM subjects presented ABI>1.2 and were excluded. Clinical and biological parameters were determined using standard methods.
  
  
  RESULTS
  Comparing clinical and biological parameters obtained in both studied groups (T2DM+ABI<0.9 vs T2DM+ABI0.9-1.2), we found statistical significant differences in age, evolution time of diabetes, Lp(a) and plasma homocysteine values. No differences were found in OS parameters: reduced glutathione, oxidized glutathione and maloldialdehide between studied groups. Plasma homocysteine values were an independent risk factor for the presence of PM and were related to evolution time of diabetes and reduced glutathione.
  
  
  CONCLUSIONS
  We have confirmed that Lp(a) and independently plasma homocysteine values were related to PM in T2DM subjects. No association with PM and OS markers (GSH, GSSG and MDA) were found in T2DM with more than 10years of evolution time of their disease and high prevalence of chronic complications.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Barcelona, España; Departamento de Medicina, Universidad de Valencia e INCLIVA, Valencia, España.
authors.forename: Jose T
authors.initials: JT
authors.lastname: Real
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: José
authors.initials: J
authors.lastname: Folgado
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Molina Mendez
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Barcelona, España; Departamento de Medicina, Universidad de Valencia e INCLIVA, Valencia, España.
authors.forename: Sergio
authors.initials: S
authors.lastname: Martinez-Hervás
authors.affiliation: CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Barcelona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Peiro
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valencia, Valencia, España; CIBER de Diabetes y Enfermedades Metabólicas asociadas (CIBERDEM), Barcelona, España; Departamento de Medicina, Universidad de Valencia e INCLIVA, Valencia, España. Electronic address: ascaso@uv.es.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Ascaso
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood* / Q000209:etiology; D005260:Female; D005978:Glutathione / Q000378:metabolism; D019803:Glutathione Disulfide / Q000378:metabolism; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a); D006710:Homocysteine; D008315:Malondialdehyde; D005978:Glutathione; D019803:Glutathione Disulfide
keywords: Ankle brachial index; Diabetes tipo 2; Estrés oxidativo; Glutathione system; Homocisteína; Homocysteine; Lp(a); Oxidative stress; Peripheral macroangiopathy; Sistema glutatión; Type 2 diabetes; Vasculopatía periférica; Índice tobillo-brazo