Hyperhomocysteinemia and Increased Risk of Retinopathy
A cross-sectional, case-control study in patients with type 2 diabetes
- Aneliya Parvanova, MD1,
- Ilian Iliev, MD12,
- Borislav D. Dimitrov, MD, MSc13,
- Federica Arnoldi, Res Nurse1,
- Jelka Zaletel, MD15,
- Giuseppe Remuzzi, MD, FRCP14 and
- Piero Ruggenenti, MD14
- 1Clinical Research Center for Rare Diseases “Aldo e Cele Daccò,” Mario Negri Institute for Pharmacological Research, Bergamo, Italy
- 2Unit of Opthalmology, Azienda Ospedaliera, Ospedali Riuniti, Bergamo, Italy
- 3Department of Social Medicine and Health Management, Medical University, Plovdiv, Bulgaria
- 4Unit of Nephrology, Azienda Ospedaliera, Ospedali Riuniti, Bergamo, Italy
- 5Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, Ljubljana, Slovenia
A cross-sectional, case-control study in patients with type 2 diabetes
Increased total plasma homocysteine (tHcy) level—secondary to excessive alcohol intake, cigarette smoking, or deficiency of methylene-tetrahydrofolate reductase—is one new identified risk factor for atherosclerotic cardiovascular diseases and for macrovascular complications of diabetes (1,2). Homocysteine (Hcy)-induced vascular damage is probably initiated by reactive oxygen species formed during Hcy auto-oxidation in plasma and results in decreased nitric oxide production, platelet activation, impaired arterial vasodilatation, and isolated systolic hypertension (1).
To assess whether hyperhomocysteinemia is also an independent risk factor for microvascular complications, we cross-sectionally studied the relations among tHcy levels, diabetic retinopathy (diagnosed by indirect ophtalmoscopy and retinal photography), insulin sensitivity and glomerular filtration rate (measured by euglycemic-hyperinsulinemic clamp and unlabeled iohexol …
