ssociation between B-Vitamin Levels (B12, B6, Folate) and D with Hyperhomocysteinemia in Patients with Type 2 Diabetes Mellitus

Abstract

Diabetes Mellitus (DM) is a metabolic condition that is increasingly linked to micronutrient deficits. Hyperhomocysteinemia (HHcy), which is caused by vitamin insufficiency, has been identified as an independent risk factor for endothelial dysfunction in Type 2 Diabetes Mellitus (T2DM). The purpose of this study was to look at the relationship between plasma homocysteine levels and vitamin status (B12, B6, folate, and vitamin D) in T2DM patients. This case-control study was carried out at Baqubah Educational Hospital between October 2020 and September 2021. It included 21 healthy controls (mean age 44.90 ± 1.47; 10 men, 11 women) and 70 clinically diagnosed T2DM patients (aged >35 years; mean age 52.94 ± 1.03; 33 men, 37 women). Blood samples were taken following an overnight fast. Enzyme-linked immunosorbent assay (ELISA) kits (SunLong Biotech Co.) were used to assess serum levels of Hcy, vitamin B12, vitamin B6, folate, and vitamin D. The results of the study showed that, in comparison to the healthy group, T2DM patients had significantly higher levels of Hcy (P < 0.01). Importantly, compared to controls, T2DM patients had significantly decreased levels of vitamin B12, B6, folate and vitamin D (P < 0.01). Based on plasma Hcy levels, patients were divided into two subgroups: T2DM with Hyperhomocysteinemia (T2DM+HHcy, n=48), which is defined as Hcy >15 µmol/L, and T2DM with Normal Hcy (T2DM+NHcy, n=22). In comparison to the T2DM subgroups and the healthy controls, the T2DM+HHcy subgroups had significantly greater Hcy concentrations and lower vitamin levels (P < 0.01). In conclusion, T2DM patients are more likely to experience vitamin insufficiency, which is strongly linked to the development of hyperhomocysteinemia. The connection between B-vitamin status and Hcy levels implies that vitamin deficiency could be a key cause to higher levels of Hcy, endothelial dysfunction, and increased cardiovascular risk in these patients.