Plasma Total Homocysteine Levels Are Associated With von Willebrand Factor, Soluble Intercellular Adhesion Molecule-1, and Soluble Tumor Necrosis Factor-α Receptors in Young Type 1 Diabetic Patients Without Clinical Evidence of Macrovascular Complications

Elevated plasma total homocysteine (tHcy) levels are a powerful risk factor for atherosclerotic vascular disease (1), but it is still unclear by which pathophysiological mechanisms tHcy may promote atherothrombosis. In both experimental animal and cell culture studies (2,3), acute hyperhomocysteinemia induces endothelial dysfunction, leading to a low-grade inflammatory state that results in increased leukocyte adherence by upregulation of cell adhesion molecules. Accordingly, an impaired endothelium-dependent flow-mediated dilation was found in nondiabetic subjects with high tHcy when compared with subjects with low tHcy levels (4). In a recent cross-sectional study (5) of both nondiabetic individuals and type 2 diabetic subjects, tHcy was significantly associated with endothelial dysfunction, as estimated from plasma von Willebrand factor (vWF), and with leukocyte adhesion, as estimated from plasma vascular cell adhesion molecule-1. To our knowledge, there is a lack of available data regarding the relationships of tHcy levels with plasma markers of endothelial dysfunction and inflammation in young type …