Inverse association between plasma homocysteine concentrations and type 2 diabetes mellitus among a middle-aged and elderly Chinese population
Introduction
Homocysteine, a sulfur-containing amino acid, is an intermediate in the metabolism of the essential amino acid methionine [1]. Elevated concentration of homocysteine has been reported to be a risk factor shared by neurodegenerative conditions [2], cardiovascular disease [3], and vascular complication of diabetes [4]. However, the exact pathological mechanism associated with homocysteine remains controversial [5], [6]. In addition, the relationship between plasma homocysteine concentrations and T2DM was inconsistent. Plasma homocysteine concentrations have been reported decreased [7], [8], [9], [10], [11], [12], increased [13], [14], [15] or unchanged [16], [17], [18] in patients with T2DM. A recent meta-analysis of case–control studies indicated that the absolute pooled mean homocysteine concentration in participants with T2DM was significantly higher than in controls [19]. Recently, a prospective study found that increased concentration of homocysteine was not significantly associated with T2DM in males or females [20]. Therefore, the relationships between plasma homocysteine concentrations and T2DM remain to be further studied.
In contrast to Europeans, Chinese had higher homocysteine concentrations and lower folic acid concentrations [20], [21], [22]. Therefore, Chinese population is appropriate to investigate the association between plasma homocysteine concentrations and T2DM [20]. In the present study we conducted a cross-sectional study using data derived from the Dongfeng-Tongji (DFTJ) cohort study to investigate the association between plasma homocysteine concentrations and T2DM in middle-aged and elderly Chinese adults.
Section snippets
Study population
The DFTJ cohort was an ongoing dynamic prospective cohort and was launched in 2008 among 27,009 retired workers of Dongfeng Motor Corporation (DMC) in Shiyan, Hubei Province. A total of 38,295 retirees agreed to participate in the first follow-up of the DFTJ cohort study, conducted from April to October 2013. More details about the study design, fundamentals, and method of the DFTJ cohort study have been previously described [23]. Analyses in the present study were conducted based on the first
Results
The study population included 19085 participants. Among them, there were 6727 individuals with normoglycemia, 8728 with IFG, and 3630 with diabetes. The average age of the present population was 62.9 years. The prevalence of T2DM was 19.0% in the present whole population, 21.8% in males, and 17.1% in females. The mean (SD) of concentrations of homocysteine was 14.7 (8.5) μmol/l in the total population, 17.8 (10.5) μmol/l in males, and 12.5 (6.0) μmol/l in females. Individuals were categorized
Discussion
In the present cross-sectional study plasma homocysteine concentrations were inversely associated with T2DM prevalence risk. Homocysteine concentrations decreased with prolonged diabetic duration.
Consistent with previous studies [10], [27], [28], males and older adults tended to have higher concentrations of plasma homocysteine. In addition, FPG and HbA1c were also inversely associated with plasma homocysteine concentrations [10], [28]. In the present population, the median (inter-quartile
Funding
This work was supported by the grants from the National Natural Science Foundation (grants NSFC-81473051, 81522040, and 81230069); the National Key Research and Development Program of China (2016YFC0900800); the 111 Project (No. B12004); the Program for Changjiang Scholars; Innovative Research Team in University of Ministry of Education of China (No. IRT1246); China Medical Board (No. 12-113), and the Program for HUST Academic Frontier Youth Team.
Contribution statement
CY, JW, TW, and MH designed the study and directed its implementation, including quality assurance and control; CY, JW, FW, XH, and HH took responsibility for the accuracy of the data analysis and wrote the first draft of the paper; JY, XM, PY, SW, YW, YL, WC, XZ, HG, YT, DZ, and HY helped supervise the field activities and designed the study's analytic strategy. All authors have read and approved the final manuscript.
Acknowledgments
The authors would like to thank all study subjects for participating in the present DFTJ-cohort study as well as all volunteers for assisting in collecting the samples and data.
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