Piazzolla G, et al. Diabetol Metab Syndr. 2019 Oct 26;11:87.
Piazzolla G, et al., conducted a cross sectional study to estimate the association between metabolic syndrome (MetS) and Hyperhomocysteinemia and the promising part of homocysteine (Hcy) in the pathogenesis of atherosclerotic complications of MetS.
Almost 300 outpatients who have MetS were randomized in this study. All patients went through a medical history collection, physical examination, blood sampling and carotid ultrasound echo-color Doppler. Into two groups, MetS patients were split according to Hcy levels, group 1: “normal” (< 10.7 μmol/l; n = 140), and group 2: “high” Hcy (≥ 10.7 μmol/l; n=160). By using Student’s t-test or Chi-square test, difference between groups were performed. By using general linear models, the impacts of potential covariates on group differences were evaluated. By using simple or multiple correlation and by linear regression, the association between continuous variables were estimated. To assess the impact of Hcy along with other potential risk factors on carotid atherosclerosis, multiple regression models were assembled.
No difference was observed in Hcy levels between smokers and non-smokers nor any statistical association between pack-years and serum Hcy levels were observed (Figure 1a and 1b). As compared to group 1, lower levels of folic acid, vitamin D, high density lipoprotein (HDL) -cholesterol and glomerular filtration rate (e-GFR) whereas higher levels of C-peptide, uric acid and triglycerides was observed in group 2. Hcy. A multiple correlation analysis between Hcy and all these variables showed positively correlation of Hcy with C-peptide and uric acid and negatively association with folic acid and e-GFR. In all patients with MetS, a significant impact of Hcy levels on IMT or carotid stenosis degree was observed; positive association between Hcy and either of these atherosclerosis clinical signs was reported (Figure 2a). Even while considering only non-smoker MetS patients, a significant positive association between Hcy and IMT or carotid stenosis was identified (Figure 2b).
This study concludes that there is positive association between MetS and hyperhomocysteinemia and a direct impact of Hcy on atherogenic process during MetS. Early correction of folic acid levels may help to prevent cardiovascular complications in MetS patients.
Figure 1: (a) Hcy levels in smoker and non-smoker patients with MetS. Values are expressed as mean ± SD, (b) Relation between pack-years and Hcy in all MetS patients. Each symbol identifies a single individual.
Figure 2: Effects of Hcy on IMT and carotid stenosis degree in all (a) and in non-smoker (b) MetS patients. Each symbol identifies a single individual.
