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Hyperhomocysteinaemia is associated with coronary events in type 2 diabetes
Author(s) -
Becker A.,
Kostense P. J.,
Bos G.,
Heine R. J.,
Dekker J. M.,
Nijpels G.,
Bouter L. M.,
Stehouwer C. D. A.
Publication year - 2003
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.2003.01113.x
Subject(s) - medicine , homocysteine , hazard ratio , type 2 diabetes , diabetes mellitus , risk factor , body mass index , population , cardiology , renal function , endocrinology , confidence interval , environmental health
. Becker A, Kostense PJ, Bos G, Heine RJ, Dekker JM, Nijpels G, Bouter LM, Stehouwer CDA (VU University Medical Center, Amsterdam, the Netherlands). Hyperhomocysteinaemia is associated with coronary events in type 2 diabetes. J Intern Med 2003; 253: 293–300. Objectives. Amongst nondiabetic individuals, a high serum homocysteine concentration is an independent but relatively weak risk factor for coronary events. However, it is not known whether homocysteine increases risk of coronary events in type 2 diabetes. Therefore, we examined the combined effect of homocysteine and type 2 diabetes on risk of fatal and nonfatal coronary events. Subjects. We assessed the 10‐year risk of coronary events associated with homocysteine amongst diabetic ( n = 140) and nondiabetic ( n = 361) individuals. Design. We did this in the Hoorn Study, a population‐based study of glucose tolerance and related complications in Caucasian men and women aged 50–75 years. Results. The incidence rate for coronary events was 2.63 (29 of 140) per 100 person‐years amongst diabetic and 1.29 (42 of 361) amongst nondiabetic individuals. Amongst diabetic individuals, risk of coronary events increased 28% for each 5‐μmol L −1 increment of homocysteine (hazard ratio, 1.28; 95% CI, 1.02–1.58). This risk was independent of age, sex, hypertension, total cholesterol, HDL‐cholesterol, cigarette smoking, body mass index and glomerular filtration rate. In nondiabetic participants, homocysteine was not associated with an increased risk of coronary events (hazard ratio for each 5‐μmol L −1 increment of homocysteine, 0.86; 0.52–1.41). Conclusions. These data suggest that homocysteine is significantly associated with coronary events in individuals with type 2 diabetes, independent of traditional cardiovascular risk factors. Investigation of the effect of treatment with vitamin B on prognosis of individuals with type 2 diabetes is warranted.