Impact of insulin resistance and nephropathy on homocysteine in type 2 diabetes.

Abstract

OBJECTIVE:

To assess the impacts of insulin resistance and renal function on plasma total homocysteine (tHcy) levels in patients with type 2 diabetes with a wide range of nephropathy.

RESEARCH DESIGN AND METHODS:

Plasma tHcy levels were measured using the enzyme immunoassay method in 75 patients with type 2 diabetes and compared with those in 54 healthy control subjects. Insulin sensitivity indexes were assessed in patients with type 2 diabetes by hyperinsulinemic-euglycemic clamp using artificial pancreas.

RESULTS:

Plasma tHcy levels and their log-translormed values (log tHcy) were significantly higher in all patients with diabetes than in control subjects (tHcy, 12.0 +/- 0.7 [SE] vs. 8.7 +/- 0.3 micromol/l, P < 0.0001; log tHcy, 1.040 +/- 0.021 vs. 0.920 +/- 0.016 micromol/l, P < 0.0001). Plasma tHcy levels in patients with diabetes were significantly increased according to degree of nephropathy (P < 0.0001). On simple regression analyses, log tHcy correlated with insulin sensitivity indexes (r = -0.319, P = 0.005) as well as creatinine clearance (r = 0.634, P < 0.0001) in all patients with diabetes. Multiple regression analyses showed that insulin sensitivity indexes (beta = -0.245) as well as creatinine clearance were independent contributors to log tHcy in all patients with diabetes (R2 = 0.750, P < 0.0001). For the 59 patients with diabetes with creatinine clearance >60 ml/min, insulin sensitivity indexes were also shown to be a significant contributor to log tHcy (beta = -0.438, R2 = 0.561, P < 0.001).

CONCLUSION:

Insulin resistance and renal function are independent determinants of tHcy levels in patients with type 2 diabetes.

• Authors: M Emoto, H Kanda, T Shoji, T Kawagishi, M Komatsu, K Mori, H Tahara, E Ishimura, M Inaba, Y Okuno, Y Nishizawa
• Journal: Diabetes care (Diabetes Care) Vol. 24 Issue 3 Pg. 533-8 (Mar 2001) ISSN: 0149-5992 [Print] United States
• PMID: 11289481 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Insulin
• Homocysteine
• Uric Acid
• Creatinine

Topics

• Blood Glucose (metabolism)
• Blood Pressure
• Creatinine (metabolism)
• Diabetes Mellitus, Type 2 (blood, physiopathology)
• Diabetic Nephropathies (blood, physiopathology)
• Female
• Glucose Clamp Technique
• Glycated Hemoglobin (analysis)
• Homocysteine (blood)
• Humans
• Infusions, Intravenous
• Insulin (administration & dosage, blood, pharmacology)
• Insulin Resistance
• Male
• Middle Aged
• Reference Values
• Regression Analysis
• Uric Acid (blood)