Estimation of Serum Homocysteine and Vitamin B12 in Type 2 Diabetes Mellitus Patients

Main Article Content

Roshni G. Sadaria
Smita N. Vasava
Jaydeepsinh D. Bhalgariya
Vruti J. Bhanushali
Manish Bhoi
Praneta Chandnani
Meet Chavda

Abstract

Background: Diabetes mellitus is a common metabolic disorder characterized by absolute or relative deficiencies in insulin secretion and/or insulin action associated with chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. Homocysteine (Hcy) is a risk factor strongly linked to cardiovascular complications in Type 2 Diabetes mellitus (T2DM). Hcy requires 5-methyltetrahydrofolate as methyl donor and vitamin B12 as a co-factor. So, Vitamin B12 deficiency will lead to hyperhomocysteinemia. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus.

Aims: To assess the serum homocysteine and vitamin B12 levels in type 2 Diabetes mellitus patients.

Methodology: The present case control study was conducted at Dhiraj hospital, Piparia, Vadodara, Gujarat, India in which 80 subjects were enrolled, out of which 40 were cases of type 2 diabetes mellitus patients and 40 were controls. The age group for the study was 35 to 70 years. Blood samples were drawn to measure RBS, HbA1c, serum homocysteine and vitamin B12. Interpretation of data was done using Medcalc software.

Results: The mean levels of serum homocysteine was higher in T2DM patients than normal healthy individuals, difference between them was statistically highly significant (p<0.0001). The mean levels of vitamin B12 was lower in T2DM patients than normal healthy individuals, difference between them was statistically highly significant (p<0.0001). There is no correlation found between Homocysteine, vitamin B12 & HbA1c.

Conclusion: A significant increase in serum Hcy level was observed in T2DM patients in our study. Raised serum Homocysteine is considered as an early marker of B12 deficiency. Hyperhomocysteinemia will lead to cardiovascular complications. Therefore, the hyperhomocysteinemia could serve as another important marker of poor diabetic control and developing complications.

Keywords:
Homocysteine, type 2 diabetes mellitus, vitamin B12.

Article Details

How to Cite
Sadaria, R. G., Vasava, S. N., Bhalgariya, J. D., Bhanushali, V. J., Bhoi, M., Chandnani, P., & Chavda, M. (2019). Estimation of Serum Homocysteine and Vitamin B12 in Type 2 Diabetes Mellitus Patients. International Journal of Biochemistry Research & Review, 28(3), 1-7. https://doi.org/10.9734/ijbcrr/2019/v28i330142
Section
Original Research Article

References

Ozder. Lipid profile abnormalities seen in T2DM patients in primary healthcare in Turkey: A cross-sectional study. Lipids in Health and Disease. 2014;13:183.

Abdulfatai B. Olokoba, Olusegun A. Obateru, et al. Type 2 diabetes mellitus: A review of current trends. Oman Medical Journal. 2012;27(4):269-273.

Twinkal R. Upadhyay, Nitin Kothari, Hitesh Shah. Association between serum B12 and serum homocysteine levels in diabetic patients on metformin. Journal of Clinical and Diagnostic Research. 2016;10(4).

Vijetha Shenoy, Veena Mehendale, Krishnan Anda Prabhu, Rajan Shetty, Pragna Rao. Correlation of serum homocysteine levels with the severity of coronary artery disease. Ind J Clin Biochem. 2014;29(3):339-344.

Davis Kibirige, Raymond Mwebaze. Vitamin B12 deficiency among patients with diabetes mellitus: Is routine screening and supplementation justified? Journal of Diabetes & Metabolic Disorders. 2013;12: 17.

Paul Ganguly, Sreyoshi Fatima Alam. Role of homocysteine in the development of cardiovascular disease. Nurtition Journal. 2015;14:6.

Homocysteine – Enzyme cycling. Autopure Sphera System Packs Kit Insert.

Vitamin B12(CLIA) Maglumi kit insert. Vitamin B12-en-EU. 2019;10(1):04.

Giulia Malaguarnera, Caterina Gagliano. Homocysteine serum levels in diabetic patients with non proliferative, proliferative and without retinopathy. Bio Med Research International. 2014;191497.

Sharique Ahmad, Nasim Akhtar, Saeeda Wasim, Shoaib Irfan. Implication of serum homocysteine level in type-2 diabetes: A pilot study. Journal of Evolution of Medical and Dental Sciences. 2015;4(40):7021-25.
DOI: 10.14260/jemds/2015/1019

Maria Onomhaguan Ebesunun, Esther Odunayo Obajobi. Elevated plasma homocysteine in type 2 diabetes mellitus: A risk factor for cardiovascular diseases. Pan African Medical Journal. 2012;12:48.

Saurabh Bansal, Sangeeta Kapoor, Singh GP, Sushil Yadav. Serum homocysteine levels in type 2 diabetes mellitus patients. International Journal of Contemporary Medical Research. 2016;3(11):3393-96.

Daniel E. Platt, Essa Hariri, Pascale Salameh, Mahmoud Merhi, Nada Sabbah, Mariana Helou, Francis Mouzaya, Rita Nemer, Yasser Al‑Sarraj, Hatem El‑Shanti, Antoine B. Abchee, Pierre A. Zalloua. Type II diabetes mellitus and hyperhomocysteinemia: A complex interaction. Diabetol Metab Syndr. 2017;9:19.

Matthew C. Pflipsen, Robert C. Oh, et al. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: A cross-sectional study. J Am Board Fam Med. 2009;22(5):528-34.

Shailendra D, Kalani R, Narayan KMV, Prabhakaran S, Tandon N, Reddy PS. Prevalence of vitamin B12 deficiency among individuals with type 2 diabetes mellitus in a South Indian rural community. Int J Basic Clin Pharmacol. 2018;7:309-14.

Akinlade KS, Agbebaku SO, Rahamon SK, Balogun WO. Vitamin b12 levels in patients with type 2 diabetes mellitus on Metformin. Ann Ibd. Pg. Med. 2015;13(2): 79-83.

Jayashri R, Venkatesan U, Rohan M, et al. Acta Diabetol. 2018;55:1283.
Available:https://doi.org/10.1007/s00592-018-1240-x

Lakshman Ramachandran, Negi NS, Gupta B. Prevalence of hyperhomocysteinemia in type-2 diabetes mellitus and its correlation with its complications. JIACM. 2012;13(4):277-81.

Keche YN, Yegnanarayan R, Bhat S. Effect of vitamin B12 supplementation on glycemic control in poorly controlled hyperhomocysteinemic type 2 diabetic patients. Bangladesh J Pharmacol. 2016;11:50-53.

Maria Onomhaguan Ebesunun, Esther Odunayo Obajobi. Elevated plasma homocysteine in type 2 diabetes mellitus: A risk factor for cardiovascular diseases. Pan African Medical Journal. 2012;12:48.