World Applied Sciences Journal 16 (9): 1269-1273, 2012
ISSN 1818-4952
© IDOSI Publications, 2012
Corresponding Author: Muhammed Khalid Shaikh, Department of Medicine, Liaquat University of Medical and Health Sciences
Jamshoro, Hyderabad (LUMHS), Sindh, Pakistan.
1269
Plasma Homocysteine Level in Patients with Diabetes mellitus
Muhammed Khalid Shaikh, Bikha Ram Devrajani, Amjad Shaikh,
Syed Zulfiquar Ali Shah, Samina Shaikh and Dolat Singh
Department of Medicine Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro, Pakistan
Abstract: This descriptive case series study evaluates the frequency of hyperhomocysteinemia in patients with
diabetes mellitus & conducted at Liaquat University Hospital Hyderabad from January 2011 to June 2011.
All patients with diabetes mellitus were further evaluated for plasma homocysteine level and also for the macro
and microvascular complication of the diabetes mellitus in association with plasma homocysteine. Out of 100
diabetic patients, 70 were type 2 diabetes and 30 patients were type 1 diabetes mellitus. The mean age and
standard deviation of patients with type 1 and type 2 diabetes mellitus was 18.63±2.51 (SD) and 51.82±4.92 (SD),
respectively. The mean ±SD for plasma homocysteine in overall subjects was 87.65±12.94. The mean random
blood glucose level was 273.74±10.55 (SD) in hyperhomocysteinemia diabetics whereas it was 135.78±8.73 (SD)
in normohomocysteinemia diabetic patients. The hyperhomocysteinemia was observed in 58 patients, of which
48 were in type 2 diabetes and 10 were in type 1 diabetes (p=0.03). Of hyperhomocysteinemic population
44(75.9%) were males and 14(24.1%) were females (p=0.02). The HbA1c was raised in 38(65.5%)
hyperhomocysteinemic patients (p=0.04). The duration of diabetes was >5 years in majority of subjects.
Regarding severity 14/58 (24%) were in moderate class, 20/58 (35%) were in intermediate class and 24/58(41%)
were in severe class of hyperhomocysteinemia (p=0.86). The macrovascular complications observed in 35(60%)
and microvascular 23(40%) hyperhomocysteinemic diabetic population (p=0.05). The chronic poor metabolic
control of diabetes mellitus is associated with elevation of plasma homocysteine concentration.
Key words: Homocysteine Hyperhomocysteinemia Diabetes Mellitus
INTRODUCTION diagnosed, [4] 90% of whom are type 2 [5]. With
Diabetes mellitus (DM) is a group of metabolic has characterized the increase as an epidemic [6]. Pakistan
diseases characterized by increase blood glucose level is estimated to have 7 million people with diabetes and
resulting from defects in insulin secretion, insulin action, presently according to WHO estimation of prevalence of
or both [1].The chronic hyperglycemia of diabetes is diabetes it is 8 in the world and by the year 2025 is
associated with long-term damage, dysfunction and expected to be 4 with 15 million people with
failure of various organs, especially the eyes, kidneys, diabetes, representing a 2 fold increase in caseload [7].
nerves, heart and blood vessels. The cross sectional The prevalence of diabetes is rapidly rising all over the
survey conducted earlier in rural and urban areas of globe at an alarming rate. Over the past 30 years, the
Pakistan upon 5433 individual which show 19% status of diabetes has changed from being considered as
prevalence of diabetes mellitus [2]. The number of people a mild disorder of the elderly to one of the major causes of
with diabetes is increasing due to population growth, morbidity and mortality affecting the youth and middle
aging, urbanization and increasing prevalence of obesity aged peoples [8].
and physical inactivity. Quantifying the prevalence of The Homocysteine (Hcy) is an amino acid, is a
diabetes and the number of people affected by diabetes, homologue of the amino acid cysteine, differing by an
now and in the future, is important to allow rational additional methylene (-CH2-) group. It is biosynthesized
planning and allocation of resources [3]. There are an from methionine by the removal of its terminal methyl
estimated 23.6 million people in the U.S. (7.8% of the group and can be recycled into methionine or converted
population) with diabetes and 17.9 million being into cysteine with the aid of B-vitamins [9]. Increased
prevalence rates doubling between 1990 and 2005, CDC
th
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