Effect of lipopenic and hypotensive treatment on homocysteine levels in type 2 diabetics

Mabrouka El Oudi¹, Zied Aouni¹, Haroun Ouertani², Chakib Mazigh², Salem Machghoul¹

¹Département de biochimie, ²Service d’endocrinologie, Hôpital militaire de Tunis, 1008 Montfleury, Tunisie

Aim: Evaluate the effect of lipopenic and hypotensive treatment on homocysteine levels.

Methods: We recruited 145 type 2 diabetics and 130 control subjects. Thirty-seven diabetics had no complications, 54 had microvascular complications and 54 had macrovascular complications. We determined the parameters homocysteine of lipid, vitamin B12, triglycerides, and folates for all subjects. Associated treatments used one or more of the following drugs, statin, fibrate, angiotensin-converting enzyme inhibitor and beta-blockers.

Results: Hyperhomocysteinemia was present in 35.6% of patients. Diabetics had elevated serum levels of triglycerides (P < 0.001), homocysteine (P < 0.01), folates (P < 0.01) and vitamin B12 (P < 0.001). A strong association was found between type 2 diabetes and hyperhomocysteinemia (P < 0.001). Diabetics with associated treatment had elevated homocysteine, vitamin B12 and folate levels when compared to diabetes-free controls. For diabetics with macrovascular complications, we found significant differences in homocysteine (P = 0.010) and folate (P = 0.014) between those taking associated drugs and those who did not. For diabetics with microvascular complications, a significant difference was found in folate only (P = 0.012).

Conclusion: Drugs used for hypertension and hyperlipidemia may have an effect on homocysteine levels, for this reason the interaction between drug action and homocysteine levels should be taken into consideration.

Keywords: type 2 diabetes, complications, homocysteine, hypolipemiant drug, hypotensive drug