Lab Med Online.  2013 Oct;3(4):213-220.

Association of Blood Homocysteine levels with Subclinical Atherosclerosis in Impaired Fasting Glucose

Affiliations
  • 1Korea Association of Health Promotion, Seoul, Korea. cellonah@hanmail.net

Abstract

BACKGROUND
Prediabetes is the condition associated with the development of type 2 diabetes and a risk of cardiovascular disease. Abnormal homocysteine levels have been found to be associated with atherosclerosis in diabetes, but not well studied in pre-diabetes. In this study we investigated the relationship between blood homocysteine levels and subclinical atherosclerosis in the individuals with impaired fasting glucose. METHOD: Individuals with impaired fasting glucose with fasting blood glucose concentrations of 100-125 mg/dL (1,537 men and 1,563 women) were selected from 10,848 health examinees who underwent an ultrasonographic examination of carotid artery during health check-up over 20 yr. The subjects were divided into 4 quartile groups depending on homocysteine levels. We investigated the association of each homocysteine quartile with abnormal carotid intima-media thickness (CIMT) and carotid plaque by using logistic regression analysis.
RESULTS
Factors associated with abnormal CIMT and carotid plaque were age, homocysteine levels, blood pressure, and fasting blood glucose levels. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth- quartile homocysteine level groups had higher odds ratios ([OR]-95% confidence interval [CI])- for abnormal CIMT (1.656 [1.11-2.47], P=0.013, 1.966 [1.32-2.93], P=0.001, respectively) and for carotid plaque (1.608 [1.01-2.56], P=0.045, 1.913 [1.22-3.00], P=0.005, respectively) than did the first quartile group.
CONCLUSION
Blood homocysteine levels showed a statistically significant correlation with subclinical atherosclerosis in individuals with impaired fasting glucose.

Keyword

Impaired fasting glucose; Homocysteine; Carotid intima-media thickness; Carotid plaque; Atherosclerosis; Diabetes

MeSH Terms

Atherosclerosis
Blood Glucose
Blood Pressure
Cardiovascular Diseases
Carotid Arteries
Carotid Intima-Media Thickness
Fasting
Glucose
Homocysteine
Humans
Logistic Models
Male
Odds Ratio
Prediabetic State
Blood Glucose
Glucose
Homocysteine

Reference

1. Glümer C, Jørgensen T, Borch-Johnsen K. Inter99 study. Prevalences of diabetes and impaired glucose regulation in a Danish population: the Inter99 study. Diabetes Care. 2003; 26:2335–2340.
2. Borch-Johnsen K, Colagiuri S, Balkau B, Glümer C, Carstensen B, Ramachandran A, et al. Creating a pandemic of prediabetes: the proposed new diagnostic criteria for impaired fasting glycaemia. Diabetologia. 2004; 47:1396–1402.
Article
3. De Vegt F, Dekker JM, Jager A, Hienkens E, Kostense PJ, Stehouwer CD, et al. Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: the Hoorn Study. JAMA. 2001; 285:2109–2113.
Article
4. Ferrannini E, Nannipieri M, Williams K, Gonzales C, Haffner SM, Stem MP. Mode of onset of type 2 diabetes from normal or impaired glucose tolerance. Diabetes. 2004; 53:160–165.
Article
5. Gerstein HC, Santaguida P, Raina P, Morrison KM, Balion C, Hunt D, et al. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res Clin Pract. 2007; 78:305–312.
Article
6. Barr EL, Bokyo EJ, Zimmer PZ, Wolfe R, Tonkin AM, Shaw JE. Continuous relationships between non-diabetic hyperglycemia and both cardiovascular disease and all cause mortality: the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. Diabetologia. 2009; 52:415–424.
Article
7. Ning F, Tuomilehto J, Pyorala K, Onat A, Soderberg S, Qiao Q. Cardiovascular disease mortality in Europeans in relation to fasting and 2h plasma glucose levels within a normoglycemic range. Diabetes Care. 2010; 33:2211–2216.
Article
8. Sourij H, Saely CH, Schmid F, Zweiker R, Marte T, Wascher TC, et al. Post-challenge hyperglycemia is strongly associated with future macrovascular events and total mortality in angiographied coronary patients. Eur Heart J. 2010; 31:1583–1590.
Article
9. World Health Organization. The World Health Report 2008. 2009. accessed 7 Jun 2009. http://www.who.int/whr/en/.
10. Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J. Intima-media thickness: A new tool for diagnosis and treatment of cardiovascular risk. J Hypertens. 2002; 20:159–169.
Article
11. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007; 115:459–467.
Article
12. Wyman RA, Mays ME, McBride PE, Stein JH. Ultrasound-detected carotid plaque as a predictor of cardiovascular events. Vasc Med. 2006; 11:123–130.
Article
13. Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr. 2008; 21:93–111.
Article
14. Clarke R, Daly L, Robinson K. Hyperhomocysteinemia: an independent risk factor for vascular disease. N Engl J Med. 1991; 324:1149–1155.
Article
15. Nygård O, Vollset SE, Refsum H. Total homocysteine and cardiovascular disease. J Intern Med. 1999; 246:425–454.
Article
16. Danesh J, Lewington S. Plasma homocysteine and coronary heart disease: systematic review of published epidemiological studies. J Cardiovasc Risk. 1998; 5:229–232.
Article
17. Tawakol A, Omland T, Gerhard M, Wu JT, Greager MA. Hyperhomocysteinemia is associated with impaired endothelium-dependent vasodilatation in humans. Circulation. 1997; 95:1119–1121.
Article
18. Welch GN, Loscalzo J. Homocysteine and atherothrombosis. N Engl J Med. 1998; 338:1042–1050.
Article
19. Hoogeveen EK, Kostense PJ, Jakobs C, Dekker JM, Nijpels G, Heine RJ, et al. Hyperhomocysteinemia increases risk of death, especially in type 2 diabetes: 5-year follow-up of the Hoorn study. Circulation. 2000; 101:1506–1511.
Article
20. Welch GN, Loscalzo J. homocysteine and atherothrombosis. N Engl J Med. 1998; 338:1042–1050.
Article
21. Liszka HA, Mainous AG 3rd, King DE, Everett CJ, Egan BM. Prehypertension and cardiovascular morbidity. Ann Fam Med. 2005; 3:294–299.
Article
22. Casella IB, Presti C, Porta RM, Sabbag CR, Bosch MA, Yamazaki Y. A practical protocol to measure common carotid artery intima-media thickness. Clinics (Sao Paulo). 2008; 63:515–520.
Article
23. American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care. 2010; 33:S11–S61.
24. Abdul-Ghani MA, Jenkinson CP, Richardson DK, Tripathy D, DeFronzo RA. Insulin secretion and action in subjects with impaired fasting glucose and impaired glucose tolerance: results from the Veterans Administration Genetic Epidemiology Study. Diabetes. 2006; 55:1430–1435.
Article
25. Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of β-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care. 2006; 29:1130–1139.
Article
26. Abdul-Ghani MA, Matsuda M, Sabbah M, Jenkinson C, Richardson DK, DeFronzo RA. The relative contribution of insulin resistance and β-cell failure to the transition from normal to impaired glucose tolerance varies in different ethnic groups. Diabetes Metab Syndr. 2007; 1:105–112.
Article
27. Ford ES, Zhao G, Li C. Pre-diabetes and the risk for cardiovascular disease: a systematic review of the evidence. J Am Coll Cardiol. 2010; 55:1310–1317.
28. Tominaga M, Eguchi H, Manaka H, Igarashi K, Kato T, Sekikawa A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose: the Funagata Diabetes Study. Diabetes Care. 1999; 22:920–924.
Article
29. DECODE Study Group. the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med. 2001; 161:397–405.
30. De Vegt F, Dekker JM, Ruhe HG, Stehouwer CD, Nijpels G, Bouter LM, et al. Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study. Diabetologia. 1999; 42:926–931.
Article
32. Vallance P, Chan N. Endothelial function and nitric oxide: clinical relevance. Heart. 2001; 85:342–350.
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