PMID- 15774574
OWN - NLM
STAT- MEDLINE
DCOM- 20050607
LR  - 20190722
IS  - 0009-9147 (Print)
IS  - 0009-9147 (Linking)
VI  - 51
IP  - 5
DP  - 2005 May
TI  - Disturbed homocysteine and methionine cycle intermediates S-adenosylhomocysteine 
      and S-adenosylmethionine are related to degree of renal insufficiency in type 2 
      diabetes.
PG  - 891-7
AB  - 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.
FAU - Herrmann, Wolfgang
AU  - Herrmann W
AD  - Department of Clinical Chemistry, Central Laboratory, Saarland University 
      Hospital, Homburg, Germany. kchwher@uniklinik-saarland.de
FAU - Schorr, Heike
AU  - Schorr H
FAU - Obeid, Rima
AU  - Obeid R
FAU - Makowski, Julia
AU  - Makowski J
FAU - Fowler, Brian
AU  - Fowler B
FAU - Kuhlmann, Martin K
AU  - Kuhlmann MK
LA  - eng
PT  - Journal Article
DEP - 20050317
PL  - England
TA  - Clin Chem
JT  - Clinical chemistry
JID - 9421549
RN  - 0 (Transcobalamins)
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 375YFJ481O (Cystathionine)
RN  - 7LP2MPO46S (S-Adenosylmethionine)
RN  - 8059-24-3 (Vitamin B 6)
RN  - 8LL8S712J7 (Methylmalonic Acid)
RN  - 935E97BOY8 (Folic Acid)
RN  - 979-92-0 (S-Adenosylhomocysteine)
RN  - AE28F7PNPL (Methionine)
RN  - K848JZ4886 (Cysteine)
RN  - P6YC3EG204 (Vitamin B 12)
SB  - IM
MH  - Aged
MH  - Cystathionine/blood
MH  - Cysteine/blood
MH  - Diabetes Mellitus, Type 2/blood/*physiopathology
MH  - Diabetic Nephropathies/*diagnosis/physiopathology
MH  - Female
MH  - Folic Acid/blood
MH  - Homocysteine/metabolism
MH  - Humans
MH  - Kidney/physiopathology
MH  - Kidney Failure, Chronic/*diagnosis/physiopathology
MH  - Male
MH  - Methionine/metabolism
MH  - Methylmalonic Acid/blood
MH  - Middle Aged
MH  - S-Adenosylhomocysteine/*metabolism
MH  - S-Adenosylmethionine/*metabolism
MH  - Transcobalamins/analysis
MH  - Vitamin B 12/blood
MH  - Vitamin B 6/blood
EDAT- 2005/03/19 09:00
MHDA- 2005/06/09 09:00
CRDT- 2005/03/19 09:00
PHST- 2005/03/19 09:00 [pubmed]
PHST- 2005/06/09 09:00 [medline]
PHST- 2005/03/19 09:00 [entrez]
AID - clinchem.2004.044453 [pii]
AID - 10.1373/clinchem.2004.044453 [doi]
PST - ppublish
SO  - Clin Chem. 2005 May;51(5):891-7. doi: 10.1373/clinchem.2004.044453. Epub 2005 Mar 
      17.