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Disturbed homocysteine and methionine cycle intermediates S-adenosylhomocysteine and S-adenosylmethionine are related to degree of renal insufficiency in type 2 diabetes.

Abstract

BACKGROUND

Diabetic nephropathy is a common complication in patients with type 2 diabetes that may increase atherothrombotic risk. Hyperhomocysteinemia (HHcy) further increases the risk in those patients. We studied concentrations of total homocysteine (tHcy) and its related metabolites S-adenosylmethionine (AdoMet) and S-adenosylhomocysteine (AdoHcy) in relation to B-vitamin status and renal function in patients with type 2 diabetes who developed diabetic nephropathy.

METHODS

The study included 93 patients with renal failure and type 2 diabetes. Chronic kidney disease was classified into four subgroups according to the National Kidney Foundation based on glomerular filtration rate plus pathologic abnormalities or markers of kidney damage.

RESULTS

Serum or plasma concentrations of the metabolites increased significantly with worsening of renal function, whereas serum concentrations of the B vitamins (folate, vitamins B12 and B6) did not differ appreciably between the groups. Moreover, plasma concentrations of AdoHcy and AdoMet were markedly increased in patients with kidney failure compared with those in stage 2 (median AdoHcy, 112.7 vs 10.5 nmol/L; median AdoMet, 162.0 vs 80.0 nmol/L). The AdoMet/AdoHcy ratio was more than 80% lower in patients with renal failure compared with stage 2. Vitamin B12 was a significant determinant of concentrations of AdoMet, tHcy, methylmalonic acid (MMA), and cystathionine.

CONCLUSIONS

Increased plasma concentrations of tHcy and methionine cycle intermediates (AdoMet, AdoHcy) are related to disturbed renal function in patients with type 2 diabetes. Vitamin B12 and/or folate are significant predictors of tHcy, cystathionine, MMA, and AdoMet. The effect of therapeutic doses of the B vitamins on AdoMet, AdoHcy, and their ratio should be tested in renal patients.

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  • Authors+Show Affiliations

    ,

    Department of Clinical Chemistry, Central Laboratory, Saarland University Hospital, Homburg, Germany. kchwher@uniklinik-saarland.de

    , , , ,

    Source

    Clinical chemistry 51:5 2005 May pg 891-7

    MeSH

    Aged
    Cystathionine
    Cysteine
    Diabetes Mellitus, Type 2
    Diabetic Nephropathies
    Female
    Folic Acid
    Homocysteine
    Humans
    Kidney
    Kidney Failure, Chronic
    Male
    Methionine
    Methylmalonic Acid
    Middle Aged
    S-Adenosylhomocysteine
    S-Adenosylmethionine
    Transcobalamins
    Vitamin B 12
    Vitamin B 6

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    15774574

    Citation

    Herrmann, Wolfgang, et al. "Disturbed Homocysteine and Methionine Cycle Intermediates S-adenosylhomocysteine and S-adenosylmethionine Are Related to Degree of Renal Insufficiency in Type 2 Diabetes." Clinical Chemistry, vol. 51, no. 5, 2005, pp. 891-7.
    Herrmann W, Schorr H, Obeid R, et al. Disturbed homocysteine and methionine cycle intermediates S-adenosylhomocysteine and S-adenosylmethionine are related to degree of renal insufficiency in type 2 diabetes. Clin Chem. 2005;51(5):891-7.
    Herrmann, W., Schorr, H., Obeid, R., Makowski, J., Fowler, B., & Kuhlmann, M. K. (2005). Disturbed homocysteine and methionine cycle intermediates S-adenosylhomocysteine and S-adenosylmethionine are related to degree of renal insufficiency in type 2 diabetes. Clinical Chemistry, 51(5), pp. 891-7.
    Herrmann W, et al. Disturbed Homocysteine and Methionine Cycle Intermediates S-adenosylhomocysteine and S-adenosylmethionine Are Related to Degree of Renal Insufficiency in Type 2 Diabetes. Clin Chem. 2005;51(5):891-7. PubMed PMID: 15774574.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Disturbed homocysteine and methionine cycle intermediates S-adenosylhomocysteine and S-adenosylmethionine are related to degree of renal insufficiency in type 2 diabetes. AU - Herrmann,Wolfgang, AU - Schorr,Heike, AU - Obeid,Rima, AU - Makowski,Julia, AU - Fowler,Brian, AU - Kuhlmann,Martin K, Y1 - 2005/03/17/ PY - 2005/3/19/pubmed PY - 2005/6/9/medline PY - 2005/3/19/entrez SP - 891 EP - 7 JF - Clinical chemistry JO - Clin. Chem. VL - 51 IS - 5 N2 - BACKGROUND: Diabetic nephropathy is a common complication in patients with type 2 diabetes that may increase atherothrombotic risk. Hyperhomocysteinemia (HHcy) further increases the risk in those patients. We studied concentrations of total homocysteine (tHcy) and its related metabolites S-adenosylmethionine (AdoMet) and S-adenosylhomocysteine (AdoHcy) in relation to B-vitamin status and renal function in patients with type 2 diabetes who developed diabetic nephropathy. METHODS: The study included 93 patients with renal failure and type 2 diabetes. Chronic kidney disease was classified into four subgroups according to the National Kidney Foundation based on glomerular filtration rate plus pathologic abnormalities or markers of kidney damage. RESULTS: Serum or plasma concentrations of the metabolites increased significantly with worsening of renal function, whereas serum concentrations of the B vitamins (folate, vitamins B12 and B6) did not differ appreciably between the groups. Moreover, plasma concentrations of AdoHcy and AdoMet were markedly increased in patients with kidney failure compared with those in stage 2 (median AdoHcy, 112.7 vs 10.5 nmol/L; median AdoMet, 162.0 vs 80.0 nmol/L). The AdoMet/AdoHcy ratio was more than 80% lower in patients with renal failure compared with stage 2. Vitamin B12 was a significant determinant of concentrations of AdoMet, tHcy, methylmalonic acid (MMA), and cystathionine. CONCLUSIONS: Increased plasma concentrations of tHcy and methionine cycle intermediates (AdoMet, AdoHcy) are related to disturbed renal function in patients with type 2 diabetes. Vitamin B12 and/or folate are significant predictors of tHcy, cystathionine, MMA, and AdoMet. The effect of therapeutic doses of the B vitamins on AdoMet, AdoHcy, and their ratio should be tested in renal patients. SN - 0009-9147 UR - https://www.unboundmedicine.com/medline/citation/15774574/Disturbed_homocysteine_and_methionine_cycle_intermediates_S_adenosylhomocysteine_and_S_adenosylmethionine_are_related_to_degree_of_renal_insufficiency_in_type_2_diabetes_ L2 - http://www.clinchem.org/cgi/pmidlookup?view=long&pmid=15774574 DB - PRIME DP - Unbound Medicine ER -