Korean Diabetes J.  2010 Jun;34(3):200-206. 10.4093/kdj.2010.34.3.200.

Homocysteine as a Risk Factor for Development of Microalbuminuria in Type 2 Diabetes

• Cho EH
• Kim EH
• Kim WG
• Jeong EH
• Koh EH
• Lee WJ
• Kim MS
• Park JY
• Lee KU

• KMID: 2222376
• DOI: http://doi.org/10.4093/kdj.2010.34.3.200

Abstract

BACKGROUND
Kidney function is critical in homocysteine clearance, and plasma homocysteine level is frequently increased in patients with renal failure. On the other hand, recent studies in animals have shown that hyperhomocysteinemia induces renal injury. In this study, we determined whether hyperhomocysteinemia can be a risk factor for the development of microalbuminuria in patients with type 2 diabetes.
METHODS
A nested case-control study. Of 887 patients with type 2 diabetes who did not have microalbuminuria at baseline, 76 developed microalbuminuria during follow-up (mean, 36.0 +/- 11.7 months; range, 18 to 76 months). The control group consisted of 152 age- and sex-matched subjects who did not develop microalbuminuria. Baseline plasma homocysteine concentrations were measured in stored samples.
RESULTS
Baseline plasma homocysteine concentrations and mean HbA1C levels during follow-up were significantly higher in patients who developed microalbuminuria than in those who remained normoalbuminuric. Multivariate logistic regression analysis showed that baseline plasma homocysteine level and mean HbA1C were independent predictors of microalbuminuria in type 2 diabetes.
CONCLUSION
Hyperhomocysteinemia was associated with increased risk of microalbuminuria in patients with type 2 diabetes supporting the concept that hyperhomocysteinemia has an etiologic role in the pathogenesis of diabetic nephropathy.

Keyword

Diabetes mellitus; Homocysteine; Microalbuminuria

MeSH Terms

Animals
Case-Control Studies
Diabetes Mellitus
Diabetic Nephropathies
Follow-Up Studies
Hand
Homocysteine
Humans
Hyperhomocysteinemia
Kidney
Logistic Models
Plasma
Renal Insufficiency
Risk Factors
Homocysteine

Figure

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  Fig. 1 Correlations between (A) basal plasma creatinine levels or (B) baseline urinary albumin excretion rate and Ln plasma homocysteine level, and between (C) follow-up urinary albumin excretion rate and Ln plasma homocysteine level among the 76 cases and 152 control subjects. UAE, urinary albumin excretion.

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  Fig. 2 Cumulative incidence of microalbuminuria per category of homocysteine level. P for trend was 0.001.

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