Estimation of Homocysteine Levels in Saudi Females with Type 2 Diabetes Mellitus

Abstract

Objective: Recent studies have suggested a crosstalk between type 2 diabetes mellitus (DM) and homocysteine (Hcy) as well as cardiovascular diseases (CVD). In DM, the levels of Hcy, the amino acid homologue of cysteine with an additional methylene (-CH2-) bridge, has been reported to be either low or elevated compared to non-diabetic controls. We performed a case-control study to investigate the relationship between Hcy level and type 2 DM and CVD in Saudi females. Subjects and methods: Subjects and methods: 100 female type 2 DM patients, in the age group of 30–45 years were enrolled along with 80 age-matched healthy females (controls). Blood samples were collected after overnight fasting and concentration of Hcy was analysed using an electrochemiluminescence immunoassay analyser. Fasting serum glucose concentrations, glycated hemoglobin, and lipid profile were automatically estimated by Siemens auto-analyser. Results: In the current study, a significant increase in Hcy levels was detected in diabetic patients compared to controls (p< 0.001). Using ANOVA, we divided the patients into moderate intermediate and hyperhomocysteinemia with respect to the plasma Hcy levels; fasting serum glucose varied directly with the Hcy levels (p<0.001). Also, the study indicated that there was an increase in lipid levels, such as TG and LDL-cholesterol with the Hcy levels. From the Atherogenic Index of Plasma (AIP = LogTG/HDL - cholesterol), it could be predicted that 60% of the diabetics had increased risk for CVD, 15% had intermediate risk and 25% had a low cardiovascular risk (p<0.05). A significantly evident and positive correlation prevailed between the increasing Hcy levels and the levels of LDL-cholesterol and glucose (r=0.934, r= 0.731, p<0.001). Conclusions: High levels of serum Hcy were found to be associated with impaired glucose metabolism and higher risk of CVD in type 2 diabetic Saudi females at Al Madinah Al Munawarah.

Keywords

• cardiovascular risk
• diabetes mellitus
• metabolic syndrome
• serum homocysteine