Increased levels of plasma homocysteine are associated with nephropathy, but not severe retinopathy in type 1 diabetes mellitus

Björn Hultberg, Elisabet Agardh, A Andersson, L Brattström, Anders Isaksson, Bodil Israelsson, Carl-David Agardh

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The reactive vascular-injuring amino acid homocysteine was measured in plasma samples from 79 well-characterized type 1 diabetic patients and 46 control subjects. Patients with proliferative retinopathy had higher homocysteine levels (15.0 +/- 6.3 mumols l-1; mean +/- SD, p less than 0.001; n = 42) than those with progressive retinopathy during a two-year period (10.4 +/- 1.6 mumols l-1; n = 12), no or minimal retinopathy (10.7 +/- 4.3 mumols l-1; n = 25), and the control subjects (11.0 +/- 3.4 mumols l-1). Within the group of patients with proliferative retinopathy increased homocysteine levels were confined to those patients that had serum creatinine levels greater than 115 mumols l-1 and/or an albumin:creatinine clearance ratio greater than or equal to 0.02 x 10(-3) (17.0 +/- 5.9 mumols l-1; n = 23), whereas those with no or only minimal nephropathy had levels (12.1 +/- 5.5 mumols l-1; n = 18) that were not different from the control group. We conclude that neither type 1 diabetes mellitus nor diabetic retinopathy per se is associated with increased plasma homocysteine levels. In contrast, homocysteine accumulates, probably owing to reduced glomerular filtration, in diabetic patients with advanced nephropathy. This suggests that homocysteine might contribute to the accelerated development of macroangiopathy seen especially in this subgroup of diabetic patients.
Original languageEnglish
Pages (from-to)277-282
JournalScandinavian Journal of Clinical & Laboratory Investigation
Issue number3
Publication statusPublished - 1991

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Unit on Vascular Diabetic Complications (013241510), Division of Clinical Chemistry and Pharmacology (013250300)

Subject classification (UKÄ)

  • Endocrinology and Diabetes
  • Medicinal Chemistry
  • Pharmacology and Toxicology

Free keywords

  • diabetes mellitus
  • Homocysteine
  • renal insufficiency
  • retinopath


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