Fasting and post—methionine load homocyst(e)ine values are correlated with microalbuminuria and could contribute to worsening vascular damage in non—insulin-dependent diabetes mellitus patients☆

Abstract 

The study aim was to assess the relationship between homocyst(e)inemia and microalbuminuria in non—insulin-dependent diabetes mellitus (NIDDM) patients. The study was performed on 33 NIDDM patients (16 males and 17 females), and 16 healthy control subjects (seven males and nine females). Plasma fasting and post—methionine load homocyst(e)ine (tHcy), together with other parameters that could modify tHcy levels, were assessed. There were no significant differences between NIDDM patients with controls for fasting tHcy (8.12 ± 3.17 v 7.19 ± 2.40 μmol/L) and post—methionine load tHcy (26.51 ± 11.50 v 25.06 ± 10.76 μmol/L). Moreover, there was a significant correlation between urinary albumin excretion (IUAE) and fasting tHcy (r = .340, P = .05) and post—methionine load tHCy (r = .502, P = .004) in NIDDM patients. Fasting tHCy was correlated both with post—methionine load tHcy (r = .429, P = .01) and with vitamin B₁₂ (r = .349, P = .04) in NIDDM patients. Microalbuminuric NIDDM patients had higher fasting tHCy (9.05 ± 3.83 μmol/L) than normoalbuminurics (7.12 ± 1.95 μmol/L). In addition, NIDDM patients with complications presented higher fasting tHcy values than the group without complications (9.61 ± 3.34 v 6.53 ± 2.09 μmol/L, Kolmogorov-Smirnov two-sample test for nonparametric data [KS] = 1.794, P = .003), without any other significant differences in the parameters considered. tHcy could be an important risk factor worsening the prognosis in NIDDM patients, especially microalbuminuric patients. Microalbuminuric NIDDM patients could be particularly prone to hyperhomocyst(e)inemia, probably due to endothelial or renal dysfunction with a reduction in the scavenging of tHcy.

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