Iperomocisteinemia e alterata tolleranza alla metionina sono correlati con la microalbiminuria e contribuiscono al danno vasclare in pazienti con diabete di tipo 2

Our aim was to assess the relationship between homocyst(e)inemia and microalbiminuria in non insulin dependent diabetes mellitus (NIDDM) patients. Our study was carried out on 33 NIDDM patients (16 M; 17 F), and 16 healthy volunteers as controls (7 M; 9 F). Fasting and post-methionine load plasma homocyst(e)ine (tHcy), together with other parameters which could modify tHcy levels were no significant differences between NIDDM patients and controls as regards fasting tHcy (8.12 ±3.17 μmol/l vs 7.19±2.40 μmol/l) and post- methionine load tHcy plasmatic values (26.51±11.50 μmol/l vs 25.06± μmol/l). Moreover, there was a significant correlation between urinary albumin excretion values and fasting tHcy (r=0.340, p=0.05) and post- methionine load tHcy (r=0.502, p=0.004) in NIDDM patients; finally fasting tHcy is correlated both with post-methionine load tHcy (r=0.429, p=0.01) and with vitamin B12 (r=0.349, p=0.04) in NIDDM patients. Besides, in NIDDM microalbuminurics alone, correlation between UAE and tHcy is stronger than in all diabetics (r=0.655, p=0.004). NIDDM patients with elevated urinary albumin excretion, presented increased values of fasting and load post load tHcy. In addition NIDDM patients with complications presented higher tHcy basal values than the group without complications (9.61±3.34 μmol/l vs 6.53±6.53±2.09 μmol/l; KS=1.794, p=0.003), without any other significant differences in the parameters considered. Homocyst(e)ine could be an important risk factor, worsening the prognosis in NIDDM patients, especially in microalbuminuric patients. Microalbuminuric NIDDM patients could have a particular proneness towards hyperhomocyst(e)inemia, probably due to endothelial or renal dysfunction, with reduction in scavenging of tHcy.