Tạp chí Tim mạch học Việt Nam

Article detail

Article detail description

Home
NGHIÊN CỨU LÂM SÀNG Issue: Số 114 BỆNH MẠCH VÀNH

Serum Homocysteine concentration in diabetes type 2 patients with chronic coronary syndrome

Trần Việt Cường: Bệnh viện Nội tiết Trung ương; Đỗ Doãn Lợi: Trường Đại học Y Hà Nội;
Published: May 30, 2025
Views: 138

Abstract

Aim: To determine serum homocysteine concentration in type 2 diabetes patients with chronic coronary syndrome (CCS) and to explore the relationship between homocysteine concentrations and some clinical and paraclinical characteristics of the above patients group.

Background: Homocysteine (Hcy) - a sulfur-containing amino acid - is a product of the methionine reduction process and is related to the formation of atherosclerotic plaque through the mechanism of increasing oxidative stress, coagulation, thickening the smooth muscle of arterial wall, and disrupting the endothelium of blood vessels.1 Therefore, increased blood homocysteine is considered an independent risk factor for coronary artery disease.

Subject and method: type 2 diabetes inpatients with chronic coronary syndrome who treated at the National Endocrinology Hospital from January 2023 to October 2023.

Method: Descriptive and cross-sectional study.

Results: 53 patients (27 men, 26 women, mean age 72.4 ± 8.6) were eligible to participate in the study. We found:

- The average serum homocysteine concentration in type 2 diabetes patients with chronic coronary syndrome is 14.95 ± 5.01 µmol/L and 54.7% of them have serum Hcy concentration > 15 µmol/L.

- The average serum homocysteine concentration in group of type 2 diabetes patients with chronic coronary syndrome and chronic kidney disease (eGFR < 60 ml/min) is 16,3 ± 4,6 µmol/L, higher than the group patients without chronic kidney disease (13,3 ± 5,1 µmol/L), and 2,98 times higher (r = 2,98; 95%CI: 0,3 – 5,7) with statistical significance with p < 0,05.

- The average serum homocysteine concentration in group of type 2 diabetes patients with chronic coronary syndrome and a history of stroke (18,3 ± 3,0 µmol/L) was higher than the group patients without history of stroke (14,3 ± 5,1 µmol/L), and 4,07 times higher (r = 4,07; 95%CI: 0,5 – 7,6) with statistical significance with p < 0,05.

- The average serum homocysteine concentration in group of type 2 diabetes patients with chronic coronary syndrome and peripheral arterial diseases (carotid artery, lower extremity artery) (18,1 ± 2,6 µmol/L) was higher than the group patients without peripheral arterial diseases (13,5 ± 5,2 µmol/L), and 4,67 times higher (r = 4,67; 95%CI: 2,0 – 7,4) with statistical significance with p < 0,05.

Conclusion: Serum homocysteine concentration in type 2 diabetic patients with chronic coronary syndrome in the study is 14.95 ± 5.01 µmol/L with the rate of hyperhomocysteinemia > 15 µmol/L being 54.7%. And serum homocysteine concentrations increased in study groups with chronic kidney disease, history of stroke, and peripheral aterial diseases.

References

1.
McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol. 1969;56(1):111-128.
2.
Soinio M, Marniemi J, Laakso M, et al. Elevated plasma homocysteine level is an independent predictor of coronary heart disease events in patients with type 2 diabetes mellitus. Ann Intern Med. 2004;140(2):94-100. doi:10.7326/0003-4819-140-2-200401200-00009
3.
Johansen OE, Birkeland KI. Preventing macrovascular disease in patients with type 2 diabetes mellitus. Am J Cardiovasc Drugs. 2003;3(4):283-297. doi:10.2165/00129784-200303040-00007
4.
Ministry of Health. Guidelines for the diagnosis and treatment of type 2 diabetes. 2020; 8-12.
5.
Ministry of Health. Clinical practice guidelines for the diagnosis and treatment of coronary artery disease. 2020; 65-74.
6.
Vu KC. Study on the value of 64-slice computed tomography in the assessment of coronary artery lesions. Doctoral thesis in Medicine. Hanoi Medical University. 2013
7.
Le KT, Ho TD. Study on the characteristics of acute coronary syndrome in patients with type 2 diabetes. Journal of Vietnamese Cardiology. 2020
8.
Nguyen TTT. Study on plasma homocysteine levels in patients with type 2 diabetes and acute coronary syndrome. Doctoral thesis in Medicine. Military Medical Academy. 2017
9.
Nguyen TBC, Ho AB. Study on blood homocysteine levels in patients with type 2 diabetes with coronary artery lesions at Hue Central Hospital. Journal of Clinical Medicine. 2021;67
10.
Pham TT, Hoang TV, Truong DC. The relationship between blood homocysteine levels and certain cardiovascular risk factors in patients with type 2 diabetes. Journal of Practical Medicine and Pharmacy. 2017;175(12):109-115
11.
Ngo DTH. Evaluation of the SYNTAX score in patients with type 2 diabetes mellitus and coronary artery disease. Master's thesis. Hue University of Medicine and Pharmacy
12.
Tran THY, Nguyen KDV. The relationship between coronary artery disease risk according to the FRAMINGHAM score and coronary risk factors in patients with type 2 diabetes. Proceedings of the 6th National Endocrinology and Diabetes Conference. 2011
13.
Dao TD, Nguyen TD, Cao VM. A survey of certain cardiovascular risk factors in patients with diabetes mellitus. Proceedings of the 6th National Endocrinology and Diabetes Conference. 2009
14.
Kumar J, Ingelsson E, Lind L, et al. No Evidence of a Causal Relationship between Plasma Homocysteine and Type 2 Diabetes: A Mendelian Randomization Study. Front Cardiovasc Med. 2015;2:11. 2015. doi:10.3389/fcvm.2015.00011
15.
Mahalle N, Kulkarni MV, Garg MK, et al. Vitamin B12 deficiency and hyperhomocysteinemia as correlates of cardiovascular risk factors in Indian subjects with coronary artery disease. J Cardiol. 2013;61(4):289-294. doi:10.1016/j.jjcc.2012.11.009
16.
Kang SS, Wong PW, Malinow MR. Hyperhomocyst(e)inemia as a risk factor for occlusive vascular disease. Annu Rev Nutr. 1992;12:279-298. doi:10.1146/annurev.nu.12.070192.001431
17.
Chandalia M, Abate N, Cabo-Chan AV Jr, et al. Hyperhomocysteinemia in Asian Indians living in the United States. J Clin Endocrinol Metab. 2003;88(3):1089-1095. doi:10.1210/jc.2002-021133
18.
Hoogeveen EK. Hyperhomocysteinemia, diabetes, cardiovascular disease - The hoorn study. The Netherlands school of primary care research. 2008; 31-41
19.
Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med. 1999;159(1):38-44. doi:10.1001/archinte.159.1.38
20.
Peng HY, Man CF, Xu J, et al. Elevated homocysteine levels and risk of cardiovascular and all-cause mortality: a meta-analysis of prospective studies. J Zhejiang Univ Sci B. 2015;16(1):78-86. doi:10.1631/jzus.B1400183
21.
Kwon SW, Kim JY, Suh YJ, et al. Prognostic Value of Elevated Homocysteine Levels in Korean Patients with Coronary Artery Disease: A Propensity Score Matched Analysis. Korean Circ J. 2016;46(2):154-160. doi:10.4070/kcj.2016.46.2.154
22.
Elias MF, Sullivan LM, D'Agostino RB, et al. Homocysteine and cognitive performance in the Framingham offspring study: age is important. Am J Epidemiol. 2005;162(7):644-653. doi:10.1093/aje/kwi259
23.
Nguyen HKN, Dang VP. A study on blood homocysteine levels in patients with coronary artery disease. Summary of research projects, 11th Vietnam National Cardiology Congress. Journal of Vietnamese Cardiology. 2005. 37-58
24.
Cao PP. The relationship between elevated plasma homocysteine and ischemic stroke. Ho Chi Minh City Journal of Medicine. 2005;9(1):127-132
25.
Nguyen VT, Nguyen MH, Pham VT. A study on the relationship between serum homocysteine levels and clinical features as well as CT scan findings of ischemic stroke during the acute phase. Journal of Military Pharmaco-medicine. 2015;11:91-97
26.
Iso H, Moriyama Y, Sato S, et al. Serum total homocysteine concentrations and risk of stroke and its subtypes in Japanese. Circulation. 2004;109(22):2766-2772. doi:10.1161/01.CIR.0000131942.77635.2D
27.
Bui TL, Doan VD, Bui MH. Characteristics of cardio-ankle vascular index in patients with type 2 diabetes with foot ulcers. VMJ. 2022;512(1). doi:10.51298/vmj.v512i1.2193

Files

Article Views138
Document Views0
Downloads0
Section NGHIÊN CỨU LÂM SÀNG
Issue Số 114
Category BỆNH MẠCH VÀNH