Association Of Homocysteine And Vascular Complications Of Type2Diabetes Mellitus And The Possible Mechanisms

Objective:To explore the characteristics of Homocysteine metabolism, and its relationship with vascular diseases in type2diabetes mellitus. And to further explore the mechanism of Hcy may be caused by vascular disease.Methods:There were a total of118participants in our study,including80with type2diabetes and38with non-diabetes. Serum homocysteine was identified with enzymatic cycling assay, and serum endothelin-1was measured with enzyme linked immunosorbent assay. Blood lipid, carotid intima-media thickness and other clinical and biochemical datas were also measured at the same time. Statistics methods were used to explore the relationship of homocysteine with diabetic vascular disease and endothelin-1. Results:l.The prevalence of central obesity,and the levels of total cholesterol, triglycerides, low density lipoprotein in Type2diabetic group were higher than the non-diabetes group (P<0.05).And compared with the non-diabetes group,the levels of high density lipoprotein in type2diabetic group were lower(P<0.01).2.Serum homocysteine levels in type2diabetes(11.79±5.93) were higher than that in non-diabetics(8.68±3.22),the difference was statistically significant (P=0.000). And the prevalence of hyperhomocysteinaemia in type2diabetic group were higher than the non-diabetes group(26.25%VS2.63%,P=0.002).3.In patients with type2diabetes, serum homocysteine had a positive relationship with the age (r=0.269,p=0.016), systolic blood pressure (r=0.267,p=0.017), and the haemoglobin A1c(r=0.413,p=0.000).And stepwise multiple regression analysis showed that systolic blood pressure, haemoglobin A1c are risk factors of hyperhomocysteinaemia.4.The levels of serum homocysteine in type2diabetes with vascular disease(13.11±5.88) were significantly higher than that in non-vascular disease group (8.32±4.60),the difference was statistically significant (P=0.001). The incidence of vascular lesions in type2diabetes with hyperhomocysteinaemia group was higher than the normal homocysteine group (90.48%VS66.10%,P=0.032). Logistic regression analysis showed that serum Hcy is an independent risk factor for T2DM patients with macrovascular and microvascular disease (P=0.013、0.028). 5. The levels of serum endothelin-1in type2diabetes with vascular disease (243.87±79.82)were higher than the non-vascular disease group (198.12±64.62), the difference was statistically significant (P=0.011). In patients with type2diabetes, serum Hcy and serum endothelin-1levels were significantly positively correlated (r=0.615,P=0.000).Conclusion:1.There is a high levels of Hcy in type2diabetes. The haemoglobin A1c and systolic blood pressure are risk factors for T2DM with hyperhomocysteinaemia;2.Hcy is related to the development of vascular complications in type2diabetes;3.Hcy may lead to diabetic vascular complications through damaging endothelial function.