Hyperhomocysteinemia and increased risk of coronary artery disease in Iranian patients with diabetes mellitus type II: a cross-sectional study

Hyperhomocysteinemia in patients with diabetes mellitus (DM) has been proposed as a new risk factor for coronary artery disease (CAD). Due to the prevalence of DM and CAD in the Iranian population and the relatively high economic burden, research on these new risk factors sounds necessary. This study investigated the relationship between hyperhomocysteinemia and coronary heart disease in patients with type 2 diabetes. This study was a hospital-based cross-sectional study performed on 100 diabetic patients with indications of coronary artery angiography. After the measurement of serum HbA1c and homocysteine, the patients went through coronary angiography and, based on the results, were divided into two groups of normal and obstructed coronary arteries. Serum homocysteine and other related risk factors were further compared between the two groups. The mean serum homocysteine of patients was 13.18 ± 3.64 μmol/L in general and 15.02 ± 3.7 μmol/L in those with coronary artery obstruction. With hyperhomocysteinemia defined as serum homocysteine of ≥ 14 μmol/L, 48% of diabetic patients had hyperhomocysteinemia, of which 83% had coronary artery obstruction. The relationship between serum homocysteine and coronary artery obstruction was significant (P < 0.001). The serum homocysteine was the highest in patients with three-vessel involvement (15.39 ± 3.5 μmol/L), which was significantly higher than those with normal coronary arteries (P < 0.001). The mean serum homocysteine of diabetic patients (type II) with coronary artery disease was significantly higher than those with normal coronary arteries. It was also significantly higher in patients with three-vessel involvement than those with no vessel involvement.