Association of Blood Homocysteine levels with Subclinical Atherosclerosis in Impaired Fasting Glucose

ABSTRACT

BACKGROUND: Prediabetes is the condition associated with the development of type 2 diabetes and a risk of cardiovascular disease. Abnormal homocysteine levels have been found to be associated with atherosclerosis in diabetes, but not well studied in pre-diabetes. In this study we investigated the relationship between blood homocysteine levels and subclinical atherosclerosis in the individuals with impaired fasting glucose. METHOD: Individuals with impaired fasting glucose with fasting blood glucose concentrations of 100-125 mg/dL (1,537 men and 1,563 women) were selected from 10,848 health examinees who underwent an ultrasonographic examination of carotid artery during health check-up over 20 yr. The subjects were divided into 4 quartile groups depending on homocysteine levels. We investigated the association of each homocysteine quartile with abnormal carotid intima-media thickness (CIMT) and carotid plaque by using logistic regression analysis. RESULTS: Factors associated with abnormal CIMT and carotid plaque were age, homocysteine levels, blood pressure, and fasting blood glucose levels. Logistic regression analysis adjusted for gender and confounding factors showed that the third- and fourth- quartile homocysteine level groups had higher odds ratios ([OR]-95% confidence interval [CI])- for abnormal CIMT (1.656 [1.11-2.47], P=0.013, 1.966 [1.32-2.93], P=0.001, respectively) and for carotid plaque (1.608 [1.01-2.56], P=0.045, 1.913 [1.22-3.00], P=0.005, respectively) than did the first quartile group. CONCLUSION: Blood homocysteine levels showed a statistically significant correlation with subclinical atherosclerosis in individuals with impaired fasting glucose.