Relation of plasma homocysteine levels to atherosclerotic vascular disease and inflammation markers in type 2 diabetic patients
A Akalin1, O Alatas2, O Colak2, F Sahin3 & B Efe1
Both hyperhomocysteinemia and increased inflammatory activity are shown to be associated with atherosclerosis. But, the relation of inflammatory activity to homocysteine levels is not well established. In the present study, we aimed to evaluate the relation of plasma homocysteine (tHcy) levels to atherosclerotic vascular disease and inflammatory activity in type 2 diabetic patients.
Ninty type 2 diabetic patients were included in the study. Forty one of the diabetic patients had established atherosclerotic vascular disease and 49 of them had no evidence of atherosclerotic vascular disease. THcy levels were measured by ELISA kits.C reactive protein (CRP), fibrinogen, eritrocyte sedimentation rate (ESR), interleukin 6(IL6), tumor necrosis factor alpha(TNFalpha) were measured as markers of inflammation. HbA1c, C-peptide and lipid parameters were studied and creatinine clearences (Ccr) were calculated.
Both tHcy levels and inflammation markers including CRP, fibrinogen, ESR, IL-6 and TNF alpha were all significantly elevated in patients with atherosclerotic vascular disease compared to patients without atherosclerotic vascular disease. Among the inflammation markers tHcy levels correlated only with TNFalpha levels significantly. THcy levels were in negative correlation with Ccr and ApoA levels. CRP, fibrinogen and ESR levels were also shown to be in negative correlation with Ccr.
Inflammatory parameters besides tHcy levels were shown to be higher in type2 diabetic patients with atherosclerotic vascular disease. Impaired renal function evidenced by decreased Ccr was a significant accompaniment of both elevated tHcy levels and inflammatory activity. Although both elevated tHcy and inflammation parameters are associated with atherosclerosis, they are not completely interrelated and the possible link between them may be renal function impairment.