FASTING AND POST-METHIONINE LOAD HOMOCYST(E)INE VALUES ARE CORRELATEDWITH MICROALBUMINURIA AND COULD CONTRIBUTE TO WORSENING VASCULAR DAMAGE IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS PATIENTS

The study aim was to assess the relationship between homocyst(e)inemia and microalbuminuria in non-insulin-dependent diabetes mellitus (NIDD M) patients. The study was performed on 33 NIDDM patients (16 males an d 17 females), and 16 healthy control subjects (seven males and nine f emales). Plasma fasting and post-methionine load homocyst(e)ine (tHcy) , together with other parameters that could modify tHcy levels, were a ssessed. There were no significant differences between NIDDM patients and controls for fasting tHcy (8.12 +/- 3.17 v 7.19 +/- 2.40 mu mol/L) and post-methionine load tHcy (26.51 +/- 11.50 v 25.06 +/- 10.76 mu m ol/L). Moreover, there was a significant correlation between urinary a lbumin excretion (UAE) and fasting tHcy (r = .340, P = .05) and post-m ethionine load tHcy (r = .502, P = .004) in NIDDM patients. Fasting tH cy was correlated both with post-methionine load tHcy (r = .429, P = . 01) and with vitamin B-12 (r = -.349. P = .04) in NIDDM patients. Micr oalbuminuric NIDDM patients had higher fasting tHcy (9.05 +/- 3.83 mu mol/L) than normoalbuminurics (7.12 +/- 1.95 mu mol/L). In addition, N IDDM patients with complications presented higher fasting tHcy values than the group without complications (9.61 +/- 3.34 v 6.53 +/- 2.09 mu mol/L, Kolmogorov-Smirnov two-sample test for nonparametric data [KS] = 1.794, P = .003), without any other significant differences in the parameters considered. tHcy could be an important risk factor worsenin g the prognosis in NIDDM patients, especially microalbuminuric patient s. Microalbuminuric NIDDM patients could be particularly prone to hype rhomocyst(e)inemia, probably due to endothelial or renal dysfunction w ith a reduction in the scavenging of tHcy. Copyright (C) 1998 by W.B. Saunders Company.