Diabetes Week
Publisher: CW Henderson
Issue: August 26, 2002
Page: 2

Endocrinology
Homocysteine linked to vascular disease in diabetic patients


2002 AUG 26 - (NewsRx.com) -- by Maria G. Essig, MS, ELS, senior medical writer - Researchers in Australia found that plasma homocysteine was associated with stroke and coronary artery disease (CAD) in diabetic patients.

Joey M. Kaye and colleagues at the Royal Perth Hospital studied the relationships among the C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene, vascular disease, and concentrations of homocysteine and folate in 746 patients, 354 with type 1 diabetes and 392 with type 2.

Significant positive correlations existed between plasma homocysteine and age, male sex, and serum urea level. Significant inverse correlations were found between homocysteine and serum folate and vitamin B12 (Homocysteine, folate, methylenetetrahydrofolate reductase genotype and vascular morbidity in diabetic subjects. Clinical Science, 2002;102(6):631-637).

The researchers discovered homocysteine was significantly associated with CAD (p<0.01) and stroke (p<0.01) after adjusting for age and sex. When folate was taken into account, these correlations remained significant (p=0.043 and p=0.019, respectively). Homocysteine was not related to the presence of the MTHFR gene or to vascular disease.

Elevated levels of total erythrocyte folate significantly correlated with the 677TT genotype (p<0.0001) in comparison with the other two genotypes. Kaye and collaborators theorized this was "almost certainly due to the diversion of 5,10-methylenetetrahydrofolate into derivates subsequent to the partial metabolic block that results from the MTHFR enzyme defect."

"In conclusion, in this clinic cohort of people with diabetes, vascular disease is related to plasma homocysteine, which is correlated with serum folate," reported Kaye et al. "The MTHFR genotype does not significantly influence either plasma homocysteine or vascular disease, despite it being a determinant of erythrocyte folate, which reflects its effect on folate metabolism."

The corresponding author for this study is Joey M. Kaye, Royal Perth Hospital, Department of Endocrinology and Diabetes, Box X2213, Perth, Western Australia 6847, Australia.

A search at www.NewsRx.net using the search term "diabetes therapy" yielded 683 articles in 54 specialized reports.

Key points reported in this study include:

• Plasma homocysteine concentration was significantly correlated with coronary artery disease and stroke in diabetic patients

• Homocysteine levels were not related to the presence of the methylenetetrahydrofolate reductase (MTHFR) gene

• Homocysteine concentration was positively correlated with age, male sex, and plasma urea, and inversely correlated with concentrations of serum folate and vitamin B12 in diabetic patients

This article was prepared by Diabetes Week editors from staff and other reports. Copyright 2002, Diabetes Week via NewsRx.com.