Hyperhomocysteinemia and impaired vasomotor function in type 2 diabetes mellitus

Eur J Clin Invest. 2002 May;32(5):328-34. doi: 10.1046/j.1365-2362.2002.00990.x.


Background: Hyperhomocysteinemia has been shown to adversely affect vascular function. The aim of this study was to determine whether hyperhomocysteinemia was independently associated with changes in endothelium-dependent and -independent vasomotor functions in patients with type 2 diabetes mellitus.

Materials and methods: Fasting homocysteine (tHcy) was measured in 123 patients with type 2 diabetes and in 61 nondiabetic controls. Endothelium-dependent and -independent vasodilation was measured using high-resolution vascular ultrasound.

Results: Plasma tHcy concentration was increased in the diabetic patients (11.1 +/- 3.7 micromol L(-1) vs. 9.8 +/- 2.9, P < 0.05). The prevalence of hyperhomocysteinemia (defined as tHcy > 15 micromol L(-1)) was higher in the diabetic patients (P < 0.05). Within group comparisons showed that both the abnormalities in endothelium-dependent and -independent vasodilation were significantly more severe in diabetic patients with tHcy 10-15 (P < 0.05) and tHcy > 15 micromol L(-1) (P < 0.05) than in those patients with tHcy < 10 micromol L(-1). When compared with nondiabetic controls matched for tHcy levels, impairment of endothelium-dependent and -independent vasodilation were already evident, even in patients with normal tHcy levels (P < 0.01). Despite significant univariate relationships between tHcy and endothelium-dependent (r = -0.24, P < 0.01) and -independent vasodilation (r = -0.33, P < 0.01) in patients with diabetes, only the relationship between tHcy and endothelium-independent vasodilation remained significant after adjusting for other cardiovascular risk factors in multiple regression analysis.

Conclusions: Impairment of endothelium-dependent and -independent vasodilation was already present in diabetic patients with normal tHcy levels, and these abnormalities became more severe with increasing tHcy levels. Only the association between tHcy and endothelium-independent vasodilation was free of other cardiovascular risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brachial Artery / diagnostic imaging
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Endothelium, Vascular / diagnostic imaging
  • Endothelium, Vascular / physiology*
  • Female
  • Homocysteine / blood
  • Humans
  • Hyperhomocysteinemia / blood
  • Hyperhomocysteinemia / complications*
  • Hyperhomocysteinemia / physiopathology
  • Male
  • Middle Aged
  • Risk Factors
  • Ultrasonography
  • Vasodilation / physiology*


  • Homocysteine