Hyperhomocysteinemia is associated with the presence of retinopathy in type 2 diabetes mellitus: the Hoorn study.
Arch Intern Med
; 160(19): 2984-90, 2000 Oct 23.
Article
de En
| MEDLINE
| ID: mdl-11041907
ABSTRACT
BACKGROUND:
Retinopathy is the leading cause of blindness among patients with type 2 diabetes mellitus (DM). Hyperhomocysteinemia is a recently recognized risk factor for cardiovascular disease, independent of established risk factors.OBJECTIVE:
To study the association between the homocysteine level and retinopathy among subjects with and without DM.METHODS:
We studied an age-, sex-, and glucose tolerance-stratified random sample of a 50- to 75-year-old general white population in the Hoorn Study (N = 625). Retinal vascular changes (retinopathy) were assessed using ophthalmoscopy and/or fundus photography. Hyperhomocysteinemia was defined as a serum total homocysteine level greater than 16 micromol/L.RESULTS:
The prevalence of retinopathy was 9.8% (28/285) in subjects with normal glucose tolerance, 11.8% (20/169) in those with impaired glucose tolerance, 9.4% (10/106) in those with newly diagnosed type 2 DM, and 32.3% (21/65) in those with known type 2 DM. The prevalence of retinopathy was 10.3% (39/380) in subjects without hypertension and 16.3% (40/245) in subjects with hypertension; it was 12.0% (64/534) in subjects with a serum total homocysteine level of 16 micromol/L or less and 16.5% (15/91) in those with a serum total homocysteine level of more than 16 micromol/L. After stratification for DM and adjustment for age, sex, glycosylated hemoglobin, and hypertension, the odds ratio (95% confidence interval) for the relation between retinopathy and hyperhomocysteinemia was 0.97 (95% confidence interval, 0.42-2.82) in patients without DM and 3.44 (95% confidence interval, 1.13-10.42) in patients with DM (P =.08 for interaction).CONCLUSION:
The findings suggest that hyperhomocysteinemia may be a risk factor for retinopathy in patients with type 2 DM, but probably not in patients without DM. Arch Intern Med. 2000;1602984-2990
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Hyperhomocystéinémie
/
Rétinopathie diabétique
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Arch Intern Med
Année:
2000
Type de document:
Article
Pays d'affiliation:
Pays-Bas