Serum homocysteine, folate, vitamin B12 levels and arterial stiffness in diabetic patients: which of them is really important in atherogenesis?
Serum homocysteine, folate, vitamin B12 levels and arterial stiffness in diabetic patients: which of them is really important in atherogenesis?
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DOI：
10.1002/dmrr.902
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发表时间：
2009-01-01
影响因子：
8
通讯作者：
Mashavi, M.
中科院分区：
文献类型：
--
作者：
Shargorodsky, M.;Boaz, M.;Mashavi, M.
目的高同型半胱氨酸血症与糖尿病大血管和微血管并发症有关。然而，同型半胱氨酸（Hcy），血清叶酸和维生素B12水平在2型糖尿病患者早期血管损伤的发展中的作用尚不清楚。本研究的目的是评估总同型半胱氨酸，叶酸，维生素B12水平和动脉硬化，广泛性atherosclerosis.Methods的早期标志物多达86例2型糖尿病患者之间的关系进行了研究。所有参与者均接受血糖、HbA（1C）、血脂、hs-CRP、内皮素、Hcy、维生素B12和叶酸的评估。采用SpygmoCor（Version7.1，AtCor Medical，Sydney，Australia）无创记录和计算机分析两个动脉部位的压力波形，测量脉搏波速度（PWV）和增强指数（AI）。同型半胱氨酸与叶酸之间无相关性。Hcy浓度与PWV（r = 0.540，p < 0.0001）和AI（r = 0.390，p < 0.0001）呈显著正相关。在PWV的一般线性模型中，即使在控制了年龄、肌酐、维生素B12和叶酸水平后，Hcy仍是PWV的独立预测因子。多元线性回归分析显示，同型半胱氨酸与动脉硬化之间的关系独立于传统的心血管危险因素。维生素B12水平与tHcy呈显著负相关（r-0. 263，p = 0. 015），与PWV轻微相关（r =-0. 212，p 0. 052）。叶酸水平和PWV之间的显着关联没有检测到。结论结果支持的假设，高同型半胱氨酸可能有一个关键的作用，在糖尿病患者动脉粥样硬化的发展。此外，维生素B12与tHcy浓度显著相关，并被确定为在不存在叶酸缺乏的糖尿病患者中与PWV略微独立相关。版权所有（C）2008约翰威利父子有限公司
Aim Hyperhomocystinaemia is associated with macro- and microangiopathic diabetic complications. However, the role of homocysteine (Hcy), serum folate, and vitamin B12 level in the development of premature vascular damage in type 2 diabetic patients is not clear. The present study was designed to assess the relationship between total Hcy, folate, and vitamin B12 levels and arterial stiffness, an early marker of generalized atherosclerosis.Methods As many as 86 subjects with type 2 diabetes mellitus were studied. All participants were evaluated for glucose, HbA(1C), lipid profile, hs-CRP, endothelin, Hcy, vitamin B12, and folate. Pulse wave velocity (PWV) and augmentation index (AI) were performed as a non-invasive recording and computer analysis of the two artery sites pressure waveform using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia).Results Hcy was significantly positively associated with age, serum creatinine, and vitamin B12 levels. No association between Hcy and folate was observed. The Hcy concentration was significantly positively associated with PWV (r = 0.540, p < 0.0001) and AI (r = 0.390, p < 0.0001). In a general linear model of PWV, Hcy emerged as an independent predictor of PWV even after controlling for age, creatinine, vitamin B12, and folate levels. In a multiple linear regression analysis, the association between Hcy and arterial stiffness was independent of traditional cardiovascular risk factors. Vitamin B12 levels were significantly inversely associated with tHcy (r -0.263, p = 0.015) and marginally associated with PWV(r = -0.212, p 0.052). Significant associations between folate levels and PWV were not detected.Conclusions The results lend support to the hypothesis that elevated Hcy may have a key role in the development of atherogenesis in diabetic patients. Additionally, vitamin B12 is significantly associated with tHcy concentrations and is identified as a marginally independent correlate of PWV in diabetic patients in the absence of folate deficiency. Copyright (C) 2008 John Wiley & Sons, Ltd.