Association Between Serum Homocysteine and Subclinical Atherosclerosis Markers in Subjects With and Without Diabetes Mellitus



Fakhrzadeh H¹ ; Mahmoudi MJ² ; Droudian Z³ ; Sharifi F¹ ; Khoob YT¹ ; Mehrdad N⁴ ; Jafaraghaei F¹ ; Badamchizadeh Z⁴ Show Affiliations
Source: Tehran University Medical Journal Published:2016

Abstract

Background: The relationship between serum homocysteine levels and cardiovascular diseases has been elucidated since many years ago. In this study, the association between serum levels of homocysteine, folic acid, and vitamin B12 with the pulse wave velocity and Buckberg index or subendocardial viability ratio was assessed in individuals with diabetes and also non-diabetic subjects. Methods: In this cross-sectional study, 58 individuals with type 2 diabetes and 36 nondiabetic people, from April to October 2013 were enrolled in Dr. Shariati Hospital affiliated to Tehran University of Medical Sciences. Anthropometric and blood pressure measurements were performed with standard methods. Fasting serum glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, Triglyceide, A1C, vitamin B12, folic acid and serum homocysteine levels as well as, highly sensitive complement-reactive protein (hs-CRP) were measured. Artherial stiffness was assessed by calculating pulse wave velocity and aortic agumentation index via Sphygmocor. In addition, Buckberg index (Subendocardial viability ratio) was assessed by dividing myocardial oxygen supply to dimand expressed as percent. The normality of distributions was evaluated by Kolmogorov-Smirnov test and linear regression models were utilized to detect associations. Results: Diabetic and non-diabetic subjects differed in terms of age, history of hypertension, serum levels of homocysteine, and LDL-C (P< 0.05). The pulse wave velocity in subjects with diabetes and without diabetes were 60.91 m/s and 41.91 m/s, respectively (P= 0.01). After adjustment for confounding factors in multivariate regression analysis pulse wave velocity was associated with age and homocysteine levels in non-diabetic group, (β equal to 0.441 and 0.345, respectively), and it was related to age, diastolic blood pressure and serum levels of c-reactive protein in subject with diabetes (β= 0.417, 0.302, and 0.262, respectively). Conclusion: Homocysteine levels in non-diabetic individuals were associated to subclinical atherosclerosis markers but we could not find this association in diabetic participants. © 2016, Tehran University of Medical Sciences. All rights reserved.