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Hyperhomocysteinaemia is a significant risk factor for white matter lesions in Japanese type 2 diabetic patients
Author(s) -
Shimomura T.,
Anan F.,
Umeno Y.,
Eshima N.,
Saikawa T.,
Yoshimatsu H.,
Fujiki M.,
Kobayashi H.
Publication year - 2008
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2008.02062.x
Subject(s) - medicine , insulin resistance , hyperintensity , body mass index , diabetes mellitus , endocrinology , risk factor , gastroenterology , triglyceride , homocysteine , type 2 diabetes , type 2 diabetes mellitus , insulin , cholesterol , magnetic resonance imaging , radiology
The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. Plasma total homocysteine (tHcy), which increases with diabetes, has been flagged as a novel predictor for cerebrovascular events. We tested the hypothesis that the presence of WML correlates with tHcy and insulin resistance in type 2 diabetic patients not receiving insulin treatment. Based on brain magnetic resonance imaging findings, 81 type 2 diabetic patients were divided into two groups, with‐WML group (57 ± 8 years, mean ± standard deviation, n = 31) and without‐WML group (57 ± 6 years, n = 50). The blood glucose level was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin, Homeostasis Model Assessment (HOMA) Index and hemoglobin A1c. The body mass index was higher in the with‐WML group than in the without‐WML group ( P < 0.05). Plasma levels of triglyceride were higher whilst high‐density lipoprotein cholesterol was lower in the with‐WML group than in the without‐WML group ( P < 0.05 and P < 0.0001 respectively). FPG ( P < 0.005), insulin concentrations ( P < 0.0001), HOMA Index ( P < 0.0001) and tHcy (<0.0001) levels were higher in the with‐WML group than in the without‐WML group. Multivariate logistic analysis revealed that WML was independently predicted by the high tHcy and insulin resistance. Our findings indicate that the presence of WML was associated with the high tHcy and insulin resistance in these Japanese patients with type 2 diabetes mellitus.