Hüseyin DEMİRCİ, Hüsamettin ERDAMAR, Zafer ONARAN, Nesrin GÖKÇINAR, Nurgül ÖRNEK

The Relationship between Serum Homocysteine Levels and Nonproliferative Diabetic Retinopathy in Type 2 Diabetes Mellitus

Amaç: Tip 2 Diabetes Mellitus (T2DM) hastalarında nonproliferatif diyabetik retinopati (NPDR) gelişimi ile serum homosistein düzeyleri arasındaki ilişkinin incelenmesi. Gereç ve Yöntem: T2DM tanısı bulunan yüz hasta ile yaş ve cinsiyet benzer 30 sağlıklı bireyden oluşan kontrol grubu çalışmaya dahil edildi. Diyabetik hastalara yapılan oftalmolojik muayene ile retinopati değerlendirmesi yapıldı. Her iki grubun kan örneklerinden homosistein, açlık kan şekeri, HbA1c, trigliserid, total kolesterol, yüksek dansiteli lipoprotein ve düşük dansiteli lipoprotein ölçümleri yapıldı. Ayrıca 24 saatlik idrar örneklerinde mikroalbumin ölçüldü. T2DM hastaları retinopati olan (Grup 1, n=32) ve retinopati olmayanlar (Grup 2, n=68) olarak iki grupta değerlendirildi. Bulgular: T2DM hasta grubu ile kontrol grubunda serum homosistein düzeyleri açısından anlamlı bir fark saptanmadı (sırasıyla 13.13 ± 4.35 ?mol/l ve 12.29 ± 4.81 ?mol/l, p>0.05). Homosistein düzeyleri diabetik retinopati bulunan hastalarda (Grup 1), diyabetik herhangi bir komplikasyonu olmayanlara (Grup 2) göre yüksek bulunsa da, aradaki fark istatistiksel olarak anlamlı değildi (sırasıyla 13.21 ± 4.23 mmol/l ve 12.96 ± 4.60 mmol/l, p>0.05). Sonuç: NPDR dışında eşlik eden bir diyabetik ve kardiyovasküler komplikasyon düzeylerinde artış olmamaktadır. Çalışmamızda serum homosistein düzeyleri ile NPDR gelişimi arasında da ilişki saptanmaması retinopatinin başlangıç aşamasında homosisteinin rolünün olmadığını düşündürmektedir

Tip 2 Diabetes Mellitus'da Serum Homosistein Düzeyleri ile Nonproliferatif Diyabetik Retinopati İlişkisi

Objective: To evaluate the relationship between serum homocysteine levels and the presence of nonproliferative diabetic retinopathy (NPDR) in type 2 Diabetes Mellitus (T2DM) patients Methods: One-hundred patients with a diagnosis of T2DM and 30 healthy control subjects whose age and sex were similar were included in this study. In diabetic patients retinopathy was assessed by ophthalmological examination. Homocysteine, fasting glucose, HbA1C, triglyceride, total cholesterol, high density lipoprotein and low density lipoprotein levels were analyzed in the blood samples in both groups. Also microalbumin levels were analyzed in 24-hour urine samples. T2DM patients were further divided into two groups according to the presence of retinopathy as patients with NPDR (Group 1, n=32) and without retinopathy (Group 2, n=68). Results: There was no statistically significant difference in the homocysteine levels between the T2DM group and the control group (13.13±4.35?mol/l and 12.29±4.81?mol/l, respectively, p>0.05). Although homocysteine levels were higher in the patients with diabetic retinopathy (Group 1) than the diabetic patients without any diabetic complication (Group 2), the difference was not statistically significant (13.21±4.23mmol/l and 12.96±4.60mmol/l, respectively, p>0.05). Conclusion: There was no increase in serum homocysteine levels in T2DM when there was no additional diabetic or cardiovascular complication other than NPDR. Our study, by demonstrating that serum homocysteine level was irrelevant to the presence of NPDR, suggests that homocysteine does not play a role at the early stages of retinopathy

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