Hyperhomocysteinemia: Risk Factors and Faster Onset of Degenerative Complications of Type 2 Diabetes in Brazzaville

Abstract

Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Among the biochemical markers associated with increased risk for cardiovascular disease, homocysteine is currently one of the predictive markers under evaluation. We investigate the link between hyperhomocysteinemia and diabetes complications in DT2 population in Brazzaville. Methodology: We conducted a cross-sectional analytical study, from October to December 2022. One hundred and fifty participants were included, 100 patients T2D (34 with complications, 33 with comorbidities, 33 without), and 50 patients controls. Sociodemographic and clinical characteristics were collected. Homocysteine (Hcy) serum levels were measured using Sandwich ELISA method. Results: Study population was composed of 50% males and 50% females with sex ratio of 1; mean age was 52.2 ± 10.8 years (30 - 83). The prevalence of hyperhomocysteinemia (HHcy) was 36% (20% moderate Hcy, 15% intermediate and 1% severe). Mean Hcy concentration was 31.9 μmol/l (18 - 103). Age, gender and physical inactivity were strongly correlated to Hcy (OR of 3.5; 9.4 and 3 respectively). Multivariate analysis showed that HHcy was a risk accelerator for degenerative complications (stroke: OR = 6.2; ischemic heart disease: 4.9; neuropathy: 9.2; retinopathy: 4.5 and peripheral arterial disease: 4.9). Conclusion: These findings suggest that hyperhomocysteinemia can be considered as a predictive marker to be taken into account in targeting cardiovascular risk in Congolese subjects with T2D.