Vascular clinical evaluation of type 2 diabetic patients according to homocysteine levels

Authors

Keywords:

Homocysteine, Diabetes mellitus type 2, Cardiovascular risk, Hyperhomocysteinemia.

Abstract

Introduction: homocysteine is an additional risk factor for cardiovascular diseases in patients with type 2 diabetes mellitus.

Objective: to evaluate type 2 diabetic patients from a vascular clinical point of view according to homocysteine levels.

Methods: a cross-sectional descriptive study was carried out at the Juan Bruno Zayas General Hospital in the period from August 2022 to January 2023. The universe consisted of 275 and a sample of 53 patients over 30 years of age, with type 2 diabetes mellitus who presented cardiovascular risk factors and met the selection criteria. The mean, standard deviation and percentage were used as summary measures.

Results: increased homocysteine levels were found in 66% of cases, with mild hyperhomocysteinemia predominating in 32.1%, in males (20.6%) and in those over 60 years of age (15.1%). High blood pressure was present in 88.7% as the most relevant cardiovascular risk factor, high LDL cholesterol and low HDL cholesterol were the most frequent lipid alterations with 64.2% and 62.3% respectively, both coinciding with the slight elevation of homocysteine by 28.3%. The thickness of the carotid intima media was the most relevant alteration of the vascular wall in 58.5%, as well as moderate arterial stiffness in 38.5%, both with slight elevation of homocysteine.

Conclusions: homocysteine levels allow us to evaluate the vascular status in type 2 diabetic patients, which is why it is considered a biomarker of cardiovascular risk.

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Author Biography

Jorge Manuel Gallego Galano, Hospital General Dr.Juan Bruno Zayas Alfonso

medico especialista de 2do grado en Medicina Interna

References

1. International Diabetes Federation [Internet]. Bruselas: FID; 2023 [actualizado 22 Nov 2023; [citado 23 Nov 2023]. Datos y cifras. Disponible en: https://idf.org/es/about-diabetes/diabetes-facts-figures/

2. The Lancet. Diabetes: a defining disease of the 21st century. [Internet]. Lancet. 06.2023;401(10394):2087.Disponible en: https://doi.org/10.1016/S0140-6736(23)01296-5

3. Oficina Nacional de Estadística e Información. Anuario Estadístico de Cuba [Internet]. La Habana: ONEI; 2023 [citado 20 Nov 2023]. Disponible en: https://www.onei.gob.cu/sites/default/files/publicaciones/2023-08/19_salud_publica-_asistencia-social-2022-edicion-2023

4. Denis-de-Armas R, Torres-Yribar W, Valdés-Rodríguez Y. La hiperhomocisteinemia como factor de riesgo en las enfermedades vasculares obstructiva. Revista Cubana de Medicina [Internet]. 2024 [citado 29 Jun 2024]; 63 Disponible en: https://revmedicina.sld.cu/index.php/med/article/view/3373

5. Rodríguez Perón JM. Biomarcadores cardiacos de aterotrombosis y su implicación en la estimación del riesgo de enfermedad cardiovascular. Rev Cubana Med Milit [Internet]. 2021 [citado 5 Jun 2024];50(2). Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/766

6. Zhou L, Liu J, An Y, Wang Y, Wang G. Plasma Homocysteine Level Is Independently Associated With Conventional Atherogenic Lipid Profile and Remnant Cholesterol in Adults. Front Cardiovasc Med. 2022;9:898305. Disponible en: https://doi.org/10.3389/fcvm.2022.898305

7. World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. [Internet]. JAMA. 2013 [acceso: 29/10/2022];310(20): 2191-4. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/1760318

8. Rosabal-Nieves E. Sobre el metabolismo de la homocisteína. Implicaciones para la nutrición. Revista Cubana de Alimentación y Nutrición [Internet]. 2016 [citado 30 Jun 2024]; 26(1):[aprox. 14p.].Disponible en: https://revalnutricion.sld.cu/index.php/rcan/article/view/13

9. Velarde Negrete Jans, Hidalgo Filipovich Rosario A., Martinez Eid Georgina, Coloccini Maria Alejandra, Uriona Trigo Monica Carola. Relación de los niveles plasmáticos de homocisteína y apolipoproteína b-100 con el riesgo cardiovascular. Rev Cient Cienc Méd [Internet]. 2022 [citado 2024 Jun 30]; 25(2): 118-124. Disponible en: https://doi.org/10.51581/rccm.v25i2.509

10. Shih YL, Shih CC, Huang TC, Chen JY. The Relationship between Elevated Homocysteine and Metabolic Syndrome in a Community-Dwelling Middle-Aged and Elderly Population in Taiwan. [Internet]. Biomedicines. 2023;11(2):378. Published 2023 Jan 27. doi:10.3390/biomedicines11020378.

11. Zhang Z, Gu X, Fang X, et al. Homocysteine and the Risk of Cardiovascular Events and All-Cause Death in Elderly Population: A Community-Based Prospective Cohort Study. Ther Clin Risk Manag. [Internet]. 2020; 16:471-481. Published 2020 May 22. doi:10.2147/TCRM.S239496.

12. Zhou L, Liu J, An Y, Wang Y, Wang G. Plasma Homocysteine Level Is Independently Associated With Conventional Atherogenic Lipid Profile and Remnant Cholesterol in Adults. Front Cardiovasc Med. [Internet]. 2022; 9:898305. Disponible en: https://doi.org/10.3389/fcvm.2022.898305

13. Laverde G. DP. La homocisteína y la enfermedad cardiovascular. Perspect Nut Hum. [Internet]. 8 de diciembre de 2013 [acceso: 10/11/2022];(16):53-66. Disponible en: https://revistas.udea.edu.co/index.php/nutricion/article/view/17868

14. Yanli L, Yi Z, Huarong X, Yuxiao W. Relationship between plasma homocysteine, serum 25-hydroxyvitamin D 3 levels and carotid intima-media thickness in young diabetic patients [J]. Journal of Clinical Medicine in Practice, [Internet]. 2020, 24(10): 45-48.DOI: 10.7619/jcmp.202010011.

15. Momin M, Fan F, Yang Y, et al. Efecto aditivo entre la homocisteína y el colesterol de lipoproteínas de baja densidad sobre la incidencia de la formación de nuevas placas carotídeas: datos de una cohorte comunitaria china. BMC Cardiovasc Disord. [Internet]. (2023) 23, 332. https://doi.org/10.1186/s12872-023-03282-z

16. Sheng L, Wu C, Bai YY, Xiao WK, Feng D, Ye P. Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women. J Geriatr Cardiol. [Internet]. 2015;12(3):251-256. doi: 10.11909/j.issn.1671-5411.2015.03.006.

17. M Shindo-Hamasaki, A., Akazawa, N., Momma, R. et al. The Association between Homocysteine, Arterial Stiffness and Executive Function Middle-age and Older Women. Artery [Internet]. Res 27, 32–37 (2021). https://doi.org/10.2991/artres.k.201102.003

Published

2024-11-11

How to Cite

1.
Gallego Galano JM, Montoya Pedrón A, Rodríguez Estenger M, Álvarez Vicario R, Benítez Casamayor YB. Vascular clinical evaluation of type 2 diabetic patients according to homocysteine levels. RM [Internet]. 2024 Nov. 11 [cited 2025 May 25];28:e3044. Available from: https://revmultimed.sld.cu/index.php/mtm/article/view/3044

Issue

Section

ARTÍCULOS ORIGINALES