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- Title
Hyperhomocysteinaemia is associated with coronary events in type 2 diabetes.
- Authors
Becker, A.; Kostense, P. J.; Bos, G.; Heine, R. J.; Dekker, J. M.; Nijpels, G.; Bouter, L. M.; Stehouwer, C. D. A.
- Abstract
<bold>Objectives: </bold>Amongst nondiabetic individuals, a high serum homocysteine concentration is an independent but relatively weak risk factor for coronary events. However, it is not known whether homocysteine increases risk of coronary events in type 2 diabetes. Therefore, we examined the combined effect of homocysteine and type 2 diabetes on risk of fatal and nonfatal coronary events.<bold>Subjects: </bold>We assessed the 10-year risk of coronary events associated with homocysteine amongst diabetic (n = 140) and nondiabetic (n = 361) individuals.<bold>Design: </bold>We did this in the Hoorn Study, a population-based study of glucose tolerance and related complications in Caucasian men and women aged 50-75 years.<bold>Results: </bold>The incidence rate for coronary events was 2.63 (29 of 140) per 100 person-years amongst diabetic and 1.29 (42 of 361) amongst nondiabetic individuals. Amongst diabetic individuals, risk of coronary events increased 28% for each 5-micromol L(-1) increment of homocysteine (hazard ratio, 1.28; 95% CI, 1.02-1.58). This risk was independent of age, sex, hypertension, total cholesterol, HDL-cholesterol, cigarette smoking, body mass index and glomerular filtration rate. In nondiabetic participants, homocysteine was not associated with an increased risk of coronary events (hazard ratio for each 5-micromol L(-1) increment of homocysteine, 0.86; 0.52-1.41).<bold>Conclusions: </bold>These data suggest that homocysteine is significantly associated with coronary events in individuals with type 2 diabetes, independent of traditional cardiovascular risk factors. Investigation of the effect of treatment with vitamin B on prognosis of individuals with type 2 diabetes is warranted.
- Subjects
CORONARY disease; TYPE 2 diabetes; HOMOCYSTEINE; TYPE 2 diabetes complications; DIABETIC angiopathies; PROPORTIONAL hazards models; HYPERHOMOCYSTEINEMIA; DISEASE complications
- Publication
Journal of Internal Medicine, 2003, Vol 253, Issue 3, p293
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1046/j.1365-2796.2003.01113.x