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      Elevated plasma homocysteine in type 2 diabetes mellitus: a risk factor for cardiovascular diseases

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          Abstract

          Background

          Elevated plasma total homocysteine (tHcy) concentration has been associated with an increased risk for cardiovascular events in type 2 diabetic individuals independent of conventional risk factors. Available study in Nigerian-Africans is scare.

          Methods

          Seventy (30 males) and (40 females) type 2 diabetes mellitus, with age mean of 54 ± 11.52 years were selected for this study and thirty apparently healthy volunteers were included as controls. The biochemical parameters and anthropometric indices were determined using standard procedures.

          Results

          Significant increases were obtained in body weight, body mass index (p<0.001) and waist circumference (p<0.012) when compared with the corresponding control values respectively. The fasting plasma glucose (p<0.01), tHcy (p<0.02), and triglyceride (p<0.03) were significantly higher in the diabetes group when compared with the corresponding control values. The plasma folic acid and vitamin B 12 (p<0.05) were significantly reduced compared to the control values. The tHcy (p<0.01) was significantly higher in the males when compared with the corresponding female value. Significant decrease was obtained in the plasma triglyceride (p<0.003) in the male patients when compared with the female patients.

          Conclusion

          Our result showed increased plasma tHcy, triglyceride and waist circumference as well as decreased folic acid and vitamin B 12 in type 2 diabetes mellitus. These alterations are risk factors for premature CVD events.

          Most cited references27

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          Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.

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            Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial.

            To assess predictors of CVD mortality among men with and without diabetes and to assess the independent effect of diabetes on the risk of CVD death. Participants in this cohort study were screened from 1973 to 1975; vital status has been ascertained over an average of 12 yr of follow-up (range 11-13 yr). Participants were 347,978 men aged 35-57 yr, screened in 20 centers for MRFIT. The outcome measure was CVD mortality. Among 5163 men who reported taking medication for diabetes, 1092 deaths (603 CVD deaths) occurred in an average of 12 yr of follow-up. Among 342,815 men not taking medication for diabetes, 20,867 deaths were identified, 8965 ascribed to CVD. Absolute risk of CVD death was much higher for diabetic than nondiabetic men of every age stratum, ethnic background, and risk factor level--overall three times higher, with adjustment for age, race, income, serum cholesterol level, sBP, and reported number of cigarettes/day (P < 0.0001). For men both with and without diabetes, serum cholesterol level, sBP, and cigarette smoking were significant predictors of CVD mortality. For diabetic men with higher values for each risk factor and their combinations, absolute risk of CVD death increased more steeply than for nondiabetic men, so that absolute excess risk for diabetic men was progressively greater than for nondiabetic men with higher risk factor levels. These findings emphasize the importance of rigorous sustained intervention in people with diabetes to control blood pressure, lower serum cholesterol, and abolish cigarette smoking, and the importance of considering nutritional-hygienic approaches on a mass scale to prevent diabetes.
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              Enzymatic determination of total serum cholesterol.

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                24 June 2012
                2012
                : 12
                : 48
                Affiliations
                [1 ]Department of Chemical Pathology and Immunology Faculty of Basic Medical Sciences, Obafemi Awolowo College of Health Sciences Olabisi Onabanjo University Sagamu, Nigeria
                [2 ]Department of Chemical Pathology Obafemi Awolowo Teaching Hospital Ile Ife, Nigeria
                Author notes
                [& ]Corresponding author: MO Ebesunun, Department of Chemical Pathology and Immunology Faculty of Basic Medical Sciences Obafemi Awolowo College of Health Sciences Olabisi Onabanjo University Sagamu, Nigeria
                Article
                PAMJ-12-48
                3428168
                22937188
                289c83d0-6c1d-47df-a686-2df64490d521
                © Maria Onomhaguan Ebesunun et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 December 2011
                : 08 May 2012
                Categories
                Research

                Medicine
                type 2 diabetes,glucose,folic acid,homocysteine,high density lipoprotein,cardiovascular disease,triglyceride,vitamin b12

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