Homocysteine and endogenous markers of renal function in type 2 diabetic patients without coronary heart disease

The aim of this study was to assess parameters of renal function and other determinants of plasma homocysteine in type 2 diabetic patients without cor onary heart disease (CHD). Fasting plasma homocysteine, serum cystatin C an d serum creatinine were determined in 183 (75 men, 108 women) Type 2 diabet ic patients without clinical evidence of CHD. Creatinine clearance was calc ulated and parameters such as blood pressure, body-mass index (BMI), and gl ycated haemoglobin (HbA(Ic)) were assessed. The urine albumin:creatinine ra tio was used to classify patients as normo-, micro- or macroalbuminuric. On e hundred and ten patients, were normoalbuminuric, 67 patients were microal buminuric and six patients were macroalbuminuric. There was no statisticall y significant difference in plasma homocysteine concentration between patie nts with normoalbuminuria and microalbuminuria. There was a trend towards i ncreasing plasma homocysteine with decreasing glomerular filtration rate (G FR) (r = -0.46; P < 0.0001). There was statistically significant correlatio n between plasma homocysteine and age (r = 0.37), serum cystatin C (r = 0.4 7), and serum creatinine (r = 0.56). Plasma homocysteine concentration was significantly higher in patients with BMI < 30 kg/m(2) and showed significa nt inverse correlation with weight (r = - 0.16; P = 0.03) and body mass ind ex (r = - 0.24; P = 0.0001). Homocysteine and serum creatinine were signifi cantly higher in males than females and higher in smokers than non smokers but was not associated with glycemic control and duration of diabetes. In c onclusion, elevated homocysteine concentration in patients with type 2 DM w ithout Ct-ID is related to age, gender, smoking, BMI and GFR. Follow up stu dies will provide further information on the association between hyperhomoc ysteinemia and the development of cardiovascular disease. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.