Evaluation of serum levels of homocysteine, C-peptide and lipid profile in type I and type II diabetic patients in Hawler province/Iraq
Background and objective: Diabetes mellitus is associated with many complications such as cardiovascular disease, even in the presence of intensive glycemic control. Homocystein takes part in the development of atherosclerosis and vascular injury and it is suggested to contribute in atherosclerotic process of diabetes mellitus. C-peptide recently used to diagnose diabetes.The present study was designed to evaluate serum levels of Homocysteine, C-peptide levels and lipid profile in diabetic patients.
Methods: This study includes 75 diabetic patients (35 type 1 and 40 type 2) and 30 controls. After 12 hours fasting, serum homocystiene, C-peptide, lipid profile, HbA1c and blood glucose were measured for patients and controls.
Results: The results showed that homocysteine level in type 1 and type 2 diabetic patients significantly increased as compared with controls. And the C-peptide level in type 1 diabetic patient was very low, while in type 2 diabetic patients and in controls was normal. The results also showed that the lipid profiles (except HDL) were increased in diabetic patients.
Conclusion: Serum homocysteine (Hcy) level and lipid profile (except HDL) are significantly elevated in diabetic patients. The C-peptide level in type 1 diabetic patient was very low, while in type 2 and controls was normal.
Tierney LM, Mcphee S, Papadakis MA. Current medical diagnosis and treatment. 7th edition. New York: Lange Medical books MC Graw-Hill; p. 1203-15. (2007).
Rother KI. Diabetes treatment bridging the divide. The New England Journal of Medicine (2007) ; 356: 1499-501.
David C, John D, Daniel D, Glenn D, Marcelle I, et al. Greenspans basic and clinical endocrinology.5th ed. New York: Lange Medical books MC Graw-Hill; (2007).
Tutunco N, Erbas T, Alikasifoglu M, Tuncblec E. Thermolabile Methylene tetrahydrofolate reductase enzyme genotype is frequent in type 2 diabetic patients with normal fasting homocysteine level. Journal of Internal Medicine (2005) ; 257: 446-53.
Nygard O, Refsum H, Uland PM. Coffee consumption and plasma total homocysteine study. AMJ Clin Nutr 1997; 65: 136-43.
Hayden M, Tygagi S. Is type 2 diabetes mellitus is a vascular disease with hyperglycemia a late manifestation. Cardiovasc Diabetole (2003) ; 2:2.
Verhoef P. Plasma total homocysteine, B vitamins, and risk of coronary atherosclerosis. Vascular biology 1997 ; 17: 989-95.
Wijekoon E, Brosnan M, Brosnan T. Homocysteine metabolism in diabetes. Metabolism 2007 ; 35: 1175-77.
Allone N, Andrew G, Jacob S, Irwin H. The kidney and homocysteine metabolism. J Am Soc Nephrol 2001 ; 12: 2181-89.
Smulder Y, Racki M, Slaats E. Fasting and post methionine homocysteine level in non insulin dependent diabetes mellitus: determinant and correlation with retinopathy, albumin urea and cardiovascular disease. Diabetes Care 1999 ; 22: 125-32.
Marques G, Fontaine M, Roger J .C-peptide: much more than a by product of insulin biosynthesis. Pancreas 2004 ; 29: 231-8.
Wickamasinghe L, Chazan B, Farrow M, Bansal S, Basso S. C-peptide response to oral glucose and its clinical role in elderly. Oxford Journals 1994 ; 21: 103-8.
Carina T, Mona L, Bengt S. Predictability of C-peptide for autoimmune diabetes in young adult diabetic patients. Pract Diab Int 2001 ; 18: 3-5.
David B . Carbohydrates. In:Carl A, Edward R, David E.editors. Tietz fundamentals of clinical chemistry.6th ed. United States of America: Saunders Elsevier (2008).
Nucitarhan S, Ozben T, Tuncer N. Serum and urine malandialdehyde levels in NIDDM patients with and without hyperlipidemia. Free Radc Biol Med 1995 ; 19: 893-6.
Hultberg B, Agardh C, Agardh E, Ardian M . Poor metabolic control early age onset and marginal folate deficiency are associated with increasing level of plasma homocysteine in insulin dependent diabetes mellitus. Scand J Clin Lab Invest 1997; 57: 595-600
Hofmann M, Kohl B, Zumbach M. Hyper homocysteinemia and endothelial dysfunction in insulin dependent diabetes mellitus. Diabetic Care 1998 ; 21: 841- 8.
Colwell JA. Elevated plasma homocysteine and diabetic vascular disease. Diabetes care 1997; 20: 1805-6.
Becker P, Kostense J, Bos G, Heine J. Hyperhomocysteinaemia is associated with coronary events in diabetes. J of Intern Med 2003; 253: 293-300.
Mushi M, Stone A, Finik B, Fonseca V. Hyper homocysteine following a methionine load in patients with non insulin dependent diabetes mellitus and macrovascular disease. Metabolism 1996 ; 45: 133-5.
Drzewoski J, Czupryniak L, Chwatko G, Bald E. Total plasma homocysteine and insulin level in type 2 diabetic patients with secondary failure to oral agent. Diabetes Care 1999 ; 22:2097-9.
Fonseca V, Mudaliar S, Schimit B, Fink L, Kern P, Henry R. Plasma homocysteine concentrations are regulated by acute hyper insulinemia in non diabetic but not type 2 diabetic patient. Metabolism 1998; 47: 686-9.
Champe P, Harvey R. Biochemistry. Lippincots illustrated review. 4th ed. New York: Lippincott Williams and Wilkins. 2008: p 416-20.
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