| Homocysteine
Levels Lower in Diabetics Plasma homocysteine levels trend lower in diabetics than in the general population. Above-average homocysteine levels in diabetics, however, are still a marker for all cause mortality in the diabetic population. Data from an Israeli study published in the June 5th issue of The Lancet show that mean plasma total homocysteine levels in 239 diabetics in a group of 1,948 men and women were significantly lower than mean levels in the total group. Propositii lived in a Jerusalem neighborhood and all were older than 50 years of age. Age-adjusted mean plasma homocysteine levels were 10.9 micromoles/L among diabetic men and 12.3 micromoles/L among nondiabetic men. Among women, mean levels were 9.8 micromoles/L for diabetics and 10.8 micromoles/L for nondiabetics. Dr. Jeremy D. Kark and colleagues at Hadassah Medical Organization and Hebrew University and at Tufts, New England Medical Center, in Boston, Massachusetts, followed the group for up to 11 years. The investigators found that homocysteine levels (despite being lower in the diabetic population) greater than 10 micromoles/L - the median for the entire group - were a marker for all-cause mortality. Investigators also speculated that low plasma homocysteine levels in diabetics could also be related to the increased glomerular filtration seen in poor control, "the association of plasma total homocysteine with 9-11 year mortality may in part reflect a decline in renal function, not adequately represented by serum creatinine....non-fasting serum glucose and glycosylated albumin were inversely associated with [total homocysteine levels], and serum creatinine was positively related." Dr. Kark and colleagues also confirmed the inverse association between plasma folate and plasma total homocysteine levels. They therefore cautioned that "...patients with diabetes should be considered a priority for clinical trials of homocysteine-lowering vitamin supplementation." |