Association between plasma homocysteine and diabetic retinopathy in type II diabetes mellitus
DOI:
https://doi.org/10.22122/cdj.v2i2.99Keywords:
Diabetes Mellitus, Diabetic Retinopathy, HyperhomocysteinemiaAbstract
BACKGROUND: Diabetic retinopathy (DR) is one of the complications occurs in patients with diabetes mellitus (DM) and is the leading cause of new onset blindness. This study aimed to determine the possible association between plasma homocysteine (Hcy) levels and the development and progression of DR.
METHODS: This case-control study enrolled diabetic patients who referred for ocular consultation from the Diabetes Clinic of Tohid Hospital in Sanandaj, Iran, in 2013. Patients with type 2 DM (n = 156) were randomly assigned to evaluate the association between Hcy and DR. Participants were randomly divided into two groups; with or without DR. Patients in both groups were matched for confounding factors. Detection and grading of retinopathy was performed by indirect ophthalmoscopy and fluorescein angiography. Glycosylated hemoglobin (HbA1c) was measured by Enzyme-linked Immunosorbent Assay and fasting plasma Hcy levels measured by chromatography. Plasma Hcy more than 15 µmol/l was defined as hyperhomocysteinemia.
RESULTS: The results showed that there were no significant differences in Hcy levels in diabetic patients with or without retinopathy. Also, we found that there was no association between HbA1c level and plasma Hcy. In addition, data analysis indicates that no association was observed between disease duration and Hcy levels.
CONCLUSION: In conclusion, we found that there was not a significant association between plasma Hcy level and DR in patients with type II DM.
References
Clark CM, Lee DA. Prevention and treatment of the complications of diabetes mellitus. N Engl J Med 1995; 332(18): 1210-7.
Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol 1984; 102(4): 527-32.
Brazionis L, Rowley K, Itsiopoulos C, Harper CA, O'Dea K. Homocysteine and diabetic retinopathy. Diabetes Care 2008; 31(1): 50-6.
Van Hecke MV, Dekker JM, Nijpels G, Teerlink T, Jakobs C, Stolk RP, et al. Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study. Clin Sci (Lond) 2008; 114(7): 479-87.
Wright AD, Martin N, Dodson PM. Homocysteine, folates, and the eye. Eye (Lond) 2008; 22(8): 989-93.
Nguyen TT, Wong TY. Retinal vascular changes and diabetic retinopathy. Curr Diab Rep 2009; 9(4): 277-83.
Moustapha A, Naso A, Nahlawi M, Gupta A, Arheart KL, Jacobsen DW, et al. Prospective study of hyperhomocysteinemia as an adverse cardiovascular risk factor in end-stage renal disease. Circulation 1998; 97(2): 138-41.
Perna AF, Ingrosso D, Lombardi C, Acanfora F, Satta E, Cesare CM, et al. Possible mechanisms of homocysteine toxicity. Kidney Int Suppl 2003; (84): S137-S140.
de Luis D, Fernandez N, Aller R. Homocysteine in patients with diabetes mellitus. Med Clin (Barc) 2004; 122(1): 27-32.
Stabler SP, Estacio R, Jeffers BW, Cohen JA, Allen RH, Schrier RW. Total homocysteine is associated with nephropathy in non-insulin-dependent diabetes mellitus. Metabolism 1999; 48(9): 1096-101.
Agardh E, Hultberg B, Agardh CD. Severe retinopathy in type 1 diabetic patients is not related to the level of plasma homocysteine. Scand J Clin Lab Invest 2000; 60(3): 169-74.
Yucel I, Yucel G, Muftuoglu F. Plasma homocysteine levels in noninsulin-dependent diabetes mellitus with retinopathy and neovascular glaucoma. Int Ophthalmol 2004; 25(4): 201-5.
Soedamah-Muthu SS, Chaturvedi N, Teerlink T, Idzior-Walus B, Fuller JH, Stehouwer CD. Plasma homocysteine and microvascular and macrovascular complications in type 1 diabetes: a cross-sectional nested case-control study. J Intern Med 2005; 258(5): 450-9.
de Luis DA, Fernandez N, Arranz ML, Aller R, Izaola O, Romero E. Total homocysteine levels relation with chronic complications of diabetes, body composition, and other cardiovascular risk factors in a population of patients with diabetes mellitus type 2. J Diabetes Complications 2005; 19(1): 42-6.
Huang EJ, Kuo WW, Chen YJ, Chen TH, Chang MH, Lu MC, et al. Homocysteine and other biochemical parameters in Type 2 diabetes mellitus with different diabetic duration or diabetic retinopathy. Clin Chim Acta 2006; 366(1-2): 293-8.
Satyanarayana A, Balakrishna N, Pitla S, Reddy PY, Mudili S, Lopamudra P, et al. Status of B-vitamins and homocysteine in diabetic retinopathy: association with vitamin-B12 deficiency and hyperhomocysteinemia. PLoS One 2011; 6(11): e26747.
Lim CP, Loo AV, Khaw KW, Sthaneshwar P, Khang TF, Hassan M, et al. Plasma, aqueous and vitreous homocysteine levels in proliferative diabetic retinopathy. Br J Ophthalmol 2012; 96(5): 704-7.
Goldstein M, Leibovitch I, Yeffimov I, Gavendo S, Sela BA, Loewenstein A. Hyperhomocysteinemia in patients with diabetes mellitus with and without diabetic retinopathy. Eye (Lond) 2004; 18(5): 460-5.
Ganapathy PS, Roon P, Moister TK, Mysona B, Smith SB. Diabetes accelerates retinal neuronal cell death in a mouse model of endogenous hyperhomocysteinemia. Ophthalmol Eye Dis 2009; 1: 3-11.
Lee CH, Chang HW, Wang IK, Lin CL, Chen TC, Wang PH, et al. Diabetes mellitus, hyperhomocystinemia and atherosclerotic vascular disease in Taiwanese chronic hemodialysis patients: a retrospective study. Ren Fail 2004; 26(3): 317-23.
Pavia C, Ferrer I, Valls C, Artuch R, Colome C, Vilaseca MA. Total homocysteine in patients with type 1 diabetes. Diabetes Care 2000; 23(1): 84-7.
Cotellessa M, Minniti G, Cerone R, Prigione F, Calevo MG, Lorini R. Low total plasma homocysteine concentrations in patients with type 1 diabetes. Diabetes Care 2001; 24(5): 969-71.
Ozmen B, Ozmen D, Turgan N, Habif S, Mutaf I, Bayindir O. Association between homocysteinemia and renal function in patients with type 2 diabetes mellitus. Ann Clin Lab Sci 2002; 32(3): 279-86.
Klein BE, Knudtson MD, Tsai MY, Klein R. The relation of markers of inflammation and endothelial dysfunction to the prevalence and progression of diabetic retinopathy: Wisconsin epidemiologic study of diabetic retinopathy. Arch Ophthalmol 2009; 127(9): 1175-82.
