Homocysteine enhances LDL fatty acid peroxidation, promoting microalbuminuria in type 2 diabetes

Ann Clin Biochem 2008;45:476-480
doi:10.1258/acb.2007.007125
© 2008 Association for Clinical Biochemistry

 

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Original Articles


Asma Kassab1,
Thouraya Ajmi2,
Manel Issaoui3,
Larbi Chaeib4,
Abdelhedi Miled1 and
Mohamed Hammami3


1 Biochemistry Laboratory, CHU F Hached Sousse;
2 Epidemiology Unit, Medicine Faculty Sousse;
3 Biochemistry Department, Medicine Faculty Monastir;
4 Endocrinology Unit, CHU F Hached Sousse, Tunisia


Corresponding author: Dr Asma Kassab. Email: kassab.asma{at}laposte.net


Background: We aimed to establish the relationship between glycated haemoglobin (HbA1c), hypertension and microalbuminuria onset in type 2 diabetes.We also intended to ascertain the metabolic action of homocysteineon LDL fatty acids and on renal function.

Methods: The study was carried out on 200 patients with type 2 diabetes and 200 healthy subjects. HbA1c, apolipoprotein B (apo B) andmicroalbuminuria were measured using immunoturbidimetric methods.Cholesterol, peroxide, urea and uric acid were assayed usingcolorimetric methods. Creatinine clearance was calculated usingthe Cockroft-Gault equation. Homocysteine was measured by immunologicalfluorescence polarization. LDL fatty acids were quantified bygas chromatography.

Results: Creatinine and microalbuminuria significantly increased in type 2 diabetes when compared with controls. Microalbuminuria was significantly correlated with HbA1c and with the presence of high blood pressure. Homocysteinaemia significantly correlated with creatinine clearance in diabetes. Linoleic acid (C18:2{omega}6) did not differ between groups. C18:2{omega}6/C18:3{omega}3 ratio was three times higher in diabetics than in controls. Total saturated fatty acids, homocysteine, H2O2 and LDL-thiobarbituric reactive substances significantly increased in microalbuminuric when compared with normoalbuminuric diabetes. Total polyunsaturated fatty acids, arachidonic acid (C20:4{omega}6), LDL-cholesterol, apoB and creatinine clearance significantly decreased in microalbuminuricwhen compared with normoalbuminuric diabetes.

Conclusion: Microalbuminuria onset is associated with renal protein oxidation that is preceded by LDL fatty acid oxidation. The latter is initiated by H2O2 produced from an auto-oxidation of homocysteineand increased metabolism of arachidonic acid towards its pro-inflammatoryeicosanoids. An oxidative stress state is the common groundof diffused vasculopathy.


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