Indication of Hyperhomocysteinemia in Type 2 Diabetes Mellitus Patients with Cardiovascular Complications
DOI:
https://doi.org/10.46568/bios.v5i1.149Keywords:
Hyperhomocysteinemia, Cardiovascular, Type 2 Diabetes mellitus, prognosis. BiomarkersAbstract
Introduction Cardiovascular disease (CVD) is one of the prominent causes of mortality in cases of chronic Type 2 diabetes mellitus (T2DM) patients and necessitates improving risk categorization. There are few available biomarkers that can assess preceding or current glycemic and cardiac status, but not prognosis. Serum homocysteine (Hcy) has been indicated and reported to be a likely biomarker that can detect cardiovascular complication in patients with T2DM. Methodology Present study details the comparative analysis of several biochemical and metabolic biomarkers including Hcy in T2DM patients with and without CVD complications. A total of eighty patients, n = 40 each in T2DM with CVD and T2DM without CVD, were included in the study. Patient’s preparation, blood sample collection and analyses of all biochemical, metabolic markers including Hcy were performed as per standard protocols. One way ANOVA was used for independent measures including Tukey HSD with level of significance at P< 0.05. Results Indication of hyperhomocysteinemia, was significantly apparent in patients with T2DM who have CVD, as compared to those with T2DM without CVD. All other biochemical and metabolic parameters manifested marked significant (P< 0.00001) elevations, which was more perceptible in T2DM CVD as compared to T2DM non CVD. Clinical relevance of high Hcy in blood in patients with T2DM CVD thus suggested being prominent risk factor for proceeding renal and cardiac complications.
References
Bachmann KN., Wang TJ. Biomarkers of cardiovascular disease: contributions to risk prediction in individuals with diabetes. Diabetologia. 2018; 61(5): 987–995. doi:10.1007/s00125-017-4442-9
Emerging Risk Factors C. Sarwar N, Gao P, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010; 375:2215–2222.
Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care. 1979; 2:120–126.
Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998; 339:229–234.
Scirica BM. Use of Biomarkers in Predicting the Onset, Monitoring the Progression, and Risk Stratification for Patients with Type 2 Diabetes Mellitus. Clin Chem. 2017; 63:186–195. [PubMed: 28062618]
St Clair L, Ballantyne CM. Biological surrogates for enhancing cardiovascular risk prediction in type 2 diabetes mellitus. Am J Cardiol. 2007; 99:80B–88B.
Berezin AE. Cardiac biomarkers in diabetes mellitus: New dawn for risk stratification? Diabetes Metab Syndr. 2017. 11 Suppl 1:S201-S208. doi: 10.1016/j.dsx.2016.12.032.
D’Agostino RB Sr, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008; 117:743–753.
Stevens RJ, Kothari V, Adler AI, Stratton IM, United Kingdom Prospective Diabetes Study G. The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). Clin Sci (Lond). 2001; 101:671–679
Wang TJ. Assessing the role of circulating, genetic, and imaging biomarkers in cardiovascular risk prediction. Circulation. 2011; 123:551–565
Kengne AP, Patel A, Colagiuri S, et al. The Framingham and UK Prospective Diabetes Study (UKPDS) risk equations do not reliably estimate the probability of cardiovascular events in a large ethnically diverse sample of patients with diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) Study. Diabetologia. 2010; 53:821–831.
Davis WA, Colagiuri S, Davis TM. Comparison of the Framingham and United Kingdom Prospective Diabetes Study cardiovascular risk equations in Australian patients with type 2 diabetes from the Fremantle Diabetes Study. Med J Aust. 2009; 190:180–184.
Bozkaya TA, Ustundag UV, Ates MS, Ulfer G, Yigit P, Kutluay SH, Selek S, Emekli N. The Relations of diabetes, trace element, oxidative stress and homocysteine in patient’s undergone off-pump coronary artery bypass surgery. Indian J of App Research, 2022; 12 (2): 72-78.
Azeemi HI, Asghar SS, Ansari B, Alam JM, Mahmood SR. Effects of exercise in fasting and postprandial conditions with metabolic profiling of fats and carbohydrates. Int J of Biol-Biotech., 2020; 17 (3): 583-587
Azeemi HI, Ansari B, Alam JM.Assessment of serum enzyme levels in various muscular dystrophy conditions. INT. J. BIOL. BIOTECH., 2018; 15 (4): 48-51 2018
Effects of exercise and metformin on lipid profile and gylcemic index in patients with Type 2 Diabetes Mellitus (T2DM). Humayun I, Azmi, Basit Ansari, Junaid Mahmood Alam, Syed Riaz Mahmood. Int J of Biol-Biotech 17 (1): 527-531 2020 b
Diazyme Laboratories. Homocysteine a Strong Risk Factor for Cardiovascular Disease: A guide to Homocysteine, correlation to human disease, and various testing methods, October 2011, 34.
Refsum H. Total Homocysteine: Guidelines for Determination in the Clinical Laboratory. Clin Lab News 2002 May;12-14 (www.aacc.org).
Refsum H, Smith AD, Ueland PM, et al. Facts and Recommendations about Total Homocysteine Determinations: An Expert Opinion. Clin Chem 2004;50(1):3-32.
Munshi MN, Stone A, Fink L, Fonseca V. Hyperhomocysteinemia following a methionine load in patients with non–insulin-dependent diabetes mellitus and macrovascular disease. Metabolism. 1996; 45: 133–135. 28.
Araki A, Sako Y, Ito H. Plasma homocysteine concentrations in Japanese patients with non–insulin-dependent diabetes mellitus: effect of parenteral methylcobalamin treatment. Atherosclerosis. 1993;103:149–157
Muzurović E, Kraljević I, Solak M, Dragnić S, Mikhailidis DP. Homocysteine and diabetes: Role in macrovascular and microvascular complications. Journal of Diabetes and its Complications, 2021; 35 (3) doi.org/10.1016/ j.jdiacomp.2020.107834.
Djuric D, Jakovljevic V, Zivkovic V, Srejovic I, Homocysteine and homocysteine-related compounds: an overview of the roles in the pathology of the cardiovascular and nervous systems. Canadian Journal of Physiology and Pharmacology, 2018; 96(10), 991–1003
Ostrakhovitch EA, Tabibzadeh S. Homocysteine and age-associated disorders. Ageing Research Reviews, 2019; 49 144–164.
Wu x, Zhang l, Miao Y. Homocysteine causes vascular endothelial dysfunction by disrupting endoplasmic reticulum redox homeostasis,” Redox Biology, 2019; 20 46–59 2019.
Shiao S, Lie A, Yu CH. Meta-analysis of homocysteine-related factors on the risk of colorectal cancer. Oncotarget, 2018; 9 (39), 25681–25697.
Lu J, Chen K, Chen W, Liu C, Jiang X, Ma Z, Li D, Shen Y, Tian H. Association of Serum Homocysteine with Cardiovascular and All-Cause Mortality in Adults with Diabetes: A Prospective Cohort Study. Oxidative Medicine and Cellular Longevity, 2022; doi.org/10.1155/2022/2156483
Zhang Z, Gu X, Fang X, Tang Z, Guan S, Liu H, Wu X, Wang C, Zhao Y. Homocysteine and the Risk of Cardiovascular Events and All-Cause Death in Elderly Population: A Community-Based Prospective Cohort Study. Therapeutics and Clinical Risk Management, 2020; 471-481, DOI: 10.2147/ TCRM.S23949.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Afsheen Sardar, Junaid Mahmood Alam, Amna Hussain, Syed Riaz Mahmood, Maqsood Ansari
This work is licensed under a Creative Commons Attribution 4.0 International License.
