Diyabetik retinopatide düşük vitamin B12, folik asit ve homosistein düzeylerinin ters ilişkisi

Inverse correlation of low vitamin B12, folic acid and homocysteine levels in diabetic retinopathy

Abstract

Purpose: Evaluation of total plasma homocysteine, serum vitamin B12 and folic acid levels in patients with diabetic retinopathy. Materials and Methods: Fifty patients having insulin dependent diabetes mellitus were included and subdivided into 3 groups: Diabetics without retinopathy (n=10), with background retinopathy (n=20), and proliferative retinopathy (n=20). Ten normal subjects served as controls. Plasma total homocysteine levels were measured using HPLC. Serum vitamin B12 and folic acid levels were carried out using radioimmunoassay technique. Results: There was a statistically significant increase of plasma total homocysteine in diabetics without retinopathy compared to controls, as well as decrease in serum levels of both serum folate and B12. There was a statistically significant decrease of serum B12 and folic acid levels and a significant increase of plasma total homocysteine level in diabetics with retinopathy in comparison to those without retinopathy. There was no association between the different degrees of retinopathy studied and plasma total homocysteine concentrations, nor serum B12 and folic acid concentrations. Conclusion: Diabetic patients with retinopathy are most prone to develop an increase in plasma total homocysteine which may be caused by a deficiency of both blood folate and vitamin B12 concentrations. This finding directs physicians to the benefit of recommending the use of those vitamins as replacement therapy in diabetics to prevent future atherogenic processes and diabetic complications due to hyperhomocysteinemia.

Özet

Amaç: Diyabetik retinopatili hastalarda total plazma homosistein, serum vitamin B12 ve folik asit düzeylerini incelemektir. Materyel ve Metod: İnsüline bağımlı diabetes mellituslu elli hasta 3 gruba ayırıldı. Retinopatisi olmayanlar (n=10), “background” retinopatililer (n=20), proliferatif retinopatililer (n=20). On normal kişi kontrol olarak kullanıldı. Plazma total homosistein düzeyleri HPLC ile ölçüldü. Serum vitamin B12 ve folik asit düzeyleri radioimmunoassay yöntemi ile çalışıldı. Bulgular: Retinopatisi olmaya diabetlilerin plazma total homosistein düzeylerinde kontrole göre anlamlı artış, serum folat ve B12 düzeylerinde azalış gözlendi. Retinopatili diyabet hastalarının retinopatisi olmayan diyabetlilere göre serum B12 ve folik asit düzeylerinde anlamlı azalış, plazma total homosistein düzeylerinde ise anlamlı artış bulundu. Çalışmada plazma retinopati derecesi ile total homosistein, serum B12 ve folik asit düzeyleri arasında bir ilişki bulunmadı. Sonuç: Retinopatisi olan diabetli hastalar, kan folat ve vitamin B12 düzeylerindeki azalmaya bağlı olarak plazma total homosistein artışı geliştirmeye eğilimlidirler. Bu bulgular, klinikte hiperhomosisteinemi nedeniyle gelişen aterojenik oluşumlar gibi diyabetik komplikasyonların önlenmesinde bu vitaminlerden yararlanabileceğini gösterir.