Comparison of homocysteine levels and deranged lipid profile as a predictor of microalbuminuria in Type 2 diabetic patients with diabetic nephropathy

Abstract

Introduction: Diabetic nephropathy is one of the major long term complications in patients with Type 2 diabetes. Microalbuminuria is an important marker to diagnose diabetic nephropathy at its earliest stages. It is also a strong indicator of the risk of atherothrombotic disease and cardiovascular disorders. Deranged lipid profile, particularly increased total cholesterol and LDL- cholesterol has been very well known to cause atherosclerosis. According to many recent studies, it has been hypothesized that increased homocysteine levels promote atherosclerosis and are independently associated with increased risk of microalbuminuria in patients of diabetic nephropathy. Objectives: This study was intended to establish the role of homocysteine as a marker of microalbuminuria, and to compare the role of homocysteine and deranged lipid profile as a predictor of the degree of microalbuminuria. Methods: This case-control study was conducted on a total of 150 subjects which were divided into three groups. Group A consisted of 60 diabetic patients with microalbuminuria. Group B consisted of 60 diabetic patients without microalbuminuria. Group C consisted of 30 healthy controls. Baseline investigations and estimation of microalbuminuria and homocysteine were performed. Statistical analysis of the results was done. Results: The study documented the stronger correlation between the degree of microalbuminuria and increased homocysteine levels(r = +0.401) in comparison to total cholestrol(r = +0.131) and also in comparison to LDL cholestrol(r = +0.246). There was significant difference in values of these three parameters among the subjects of three groups.(p 0.001). Conclusions: The study showed that increased homocysteine level is a better indicator of the degree of microalbuminuria in comparison to total cholestrol and also in comparison to LDL cholestrol.