Association between Hyperhomocysteinemia and Microangiopathic Complications (Neuropathy and Nephropathy) in Subjects with Type 1 and Type 2 Diabetes  

作　　者：Nene Oumou Kesso Barry Soukeyna Gueye Moustapha Djité Pape Matar Kandji Michel Assane Ndour El Hadj Malick Ndour Demba Diedhiou Fatou Gueye-Tall Ndeye Mareme Thioune Najah Fatou Coly Dominique Doupa Maïmouna Ndour Mbaye Philomène Lopez Sall Papa Madieye Gueye Nene Oumou Kesso Barry;Soukeyna Gueye;Moustapha Djité;Pape Matar Kandji;Michel Assane Ndour;El Hadj Malick Ndour;Demba Diedhiou;Fatou Gueye-Tall;Ndeye Mareme Thioune;Najah Fatou Coly;Dominique Doupa;Maïmouna Ndour Mbaye;Philomène Lopez Sall;Papa Madieye Gueye(Laboratory of Pharmaceutical Biochemistry, University Cheikh Anta DIOP, Dakar, Senegal;Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal;Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal;Medical Biology Laboratory, Diamniadio Children Hospital, Dakar, Senegal;Department of Medical Biochemistry, Saint-Louis University, Saint-Louis, Senegal)

机构地区：[1]Laboratory of Pharmaceutical Biochemistry, University Cheikh Anta DIOP, Dakar, Senegal [2]Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal [3]Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal [4]Medical Biology Laboratory, Diamniadio Children Hospital, Dakar, Senegal [5]Department of Medical Biochemistry, Saint-Louis University, Saint-Louis, Senegal

出　　处：《Journal of Diabetes Mellitus》2023年第4期325-339,共15页糖尿病（英文）

摘　　要：This prospective case-control study aimed to assess the prevalence of hyperhomocysteinemia and explore its potential correlation with microangiopathic complications, specifically nephropathy and neuropathy, in a cohort of both type 1 and type 2 diabetic patients. Conducted at the Marc Sankalé Center of Abass Ndao Hospital in Dakar from June to September 2018, the study enrolled a total of 106 diabetic patients, comprising 93 type 2 diabetics and 13 type 1 diabetics, who were matched with control subjects free from clinically detectable pathologies, based on sex and age ± 2 years. The mean age of type 1 and type 2 diabetic patients was 24.46 ± 8.41 years and 57.28 ± 11.28 years, respectively. Our findings revealed a statistically significant elevation in mean homocysteine levels among patients when compared to controls (12.63 vs. 9.88;p < 0.0001). Hyperhomocysteinemia was observed in 24.5% of the patients, exclusively among those with type 2 diabetes. Within the hyperhomocysteinemia subgroup, 58% were male, and 42% were female. The analysis of neuropathy and nephropathy frequencies among type 2 diabetic patients, stratified by homocysteine concentrations, demonstrated a notably higher prevalence of diabetic nephropathy in patients with hyperhomocysteinemia compared to those with normohomocysteinemia (23.07% vs. 8.75%;p = 0.052). Similarly, diabetic neuropathy exhibited a significantly greater frequency in patients with hyperhomocysteinemia as opposed to normohomocysteinemia (80.76% vs. 50%;p = 0.005). Furthermore, our results established a significant positive correlation between homocysteine concentrations and both age (r = 0.402;p < 0.0001) and creatinine levels (r = 0.461;p < 0.0001). Bivariate logistic regression analysis indicated that patients with hyperhomocysteinemia faced 3 times and 6 times higher risks of developing neuropathy (OR = 3.5;p = 0.061) and diabetic nephropathy (OR = 6.092;p = 0.014), respectively.This prospective case-control study aimed to assess the prevalence of hyperhomocysteinemia and explore its potential correlation with microangiopathic complications, specifically nephropathy and neuropathy, in a cohort of both type 1 and type 2 diabetic patients. Conducted at the Marc Sankalé Center of Abass Ndao Hospital in Dakar from June to September 2018, the study enrolled a total of 106 diabetic patients, comprising 93 type 2 diabetics and 13 type 1 diabetics, who were matched with control subjects free from clinically detectable pathologies, based on sex and age ± 2 years. The mean age of type 1 and type 2 diabetic patients was 24.46 ± 8.41 years and 57.28 ± 11.28 years, respectively. Our findings revealed a statistically significant elevation in mean homocysteine levels among patients when compared to controls (12.63 vs. 9.88;p < 0.0001). Hyperhomocysteinemia was observed in 24.5% of the patients, exclusively among those with type 2 diabetes. Within the hyperhomocysteinemia subgroup, 58% were male, and 42% were female. The analysis of neuropathy and nephropathy frequencies among type 2 diabetic patients, stratified by homocysteine concentrations, demonstrated a notably higher prevalence of diabetic nephropathy in patients with hyperhomocysteinemia compared to those with normohomocysteinemia (23.07% vs. 8.75%;p = 0.052). Similarly, diabetic neuropathy exhibited a significantly greater frequency in patients with hyperhomocysteinemia as opposed to normohomocysteinemia (80.76% vs. 50%;p = 0.005). Furthermore, our results established a significant positive correlation between homocysteine concentrations and both age (r = 0.402;p < 0.0001) and creatinine levels (r = 0.461;p < 0.0001). Bivariate logistic regression analysis indicated that patients with hyperhomocysteinemia faced 3 times and 6 times higher risks of developing neuropathy (OR = 3.5;p = 0.061) and diabetic nephropathy (OR = 6.092;p = 0.014), respectively.

关 键 词：HOMOCYSTEINE HYPERHOMOCYSTEINEMIA Diabetes Mellitus Type 1 Diabetes Type 2 Diabetes NEPHROPATHY NEUROPATHY 

分 类 号：R58[医药卫生—内分泌]