The aim of the present study was to investigate the relationship between homocysteine and homocysteine metabolism components and retinal microvascular disorders in subjects with and without Type 2 diabetes. In this population-based study of 256 participants, aged 60–85 years, we determined total plasma homocysteine, SAM (S-adenosylmethionine) and SAH (S-adenosylhomocysteine) in plasma and erythrocytes, total folate in serum and erythrocytes, 5-MTHF (5-methyltetrahydrofolate), and vitamins B12 and B6. Participants were examined ophthalmologically by means of indirect funduscopy and two-field 45 ° fundus photography, and were graded for retinopathy and retinal sclerotic vessel abnormalities. A computer-assisted method was used to measure retinal vessel diameters. Total plasma homocysteine was inversely associated with retinal arteriolar diameters {standardized β, −0.20 [95% CI (confidence interval), −0.33 to −0.07]} or a decrease of 3.78 μm CRAEs (central retinal arteriolar equivalents) per 1 S.D. increase in homocysteine level (=4.6 μmol/l). In addition, the SAM/SAH ratio in plasma was inversely associated with retinal sclerotic vessel abnormalities and retinopathy [odds ratios, 0.61 (95% CI, 0.39–0.96) and 0.50 (95% CI, 0.30–0.83) per 1 S.D. respectively]. The associations were independent of age, sex, glucose tolerance status, other homocysteine metabolism components and cardiovascular risk factors. In conclusion, the results of the present study support the concept that total plasma homocysteine and a low SAM/SAH ratio in plasma, which may reflect reduced transmethylation reactions, may contribute to the pathogenesis of (retinal) microangiopathy.
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Research Article|
February 29 2008
Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study
Manon V. Van Hecke;
*Department of Ophthalmology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
Correspondence: Dr Manon V. van Hecke (email [email protected]).
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Jacqueline M. Dekker;
Jacqueline M. Dekker
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Giel Nijpels;
Giel Nijpels
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Tom Teerlink;
Tom Teerlink
‡Department of Clinical Chemistry, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Cornelis Jakobs;
Cornelis Jakobs
‡Department of Clinical Chemistry, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Ronald P. Stolk;
Ronald P. Stolk
§Department of Epidemiology and Bioinformatics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Rob J. Heine;
Rob J. Heine
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
∥Department of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Lex M. Bouter;
Lex M. Bouter
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Bettine C.P. Polak;
Bettine C.P. Polak
*Department of Ophthalmology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
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Coen D.A. Stehouwer
Coen D.A. Stehouwer
†Institute for Research in Extramural Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
¶Department of Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands
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Publisher: Portland Press Ltd
Received:
August 02 2007
Revision Received:
September 24 2007
Accepted:
October 24 2007
Accepted Manuscript online:
October 24 2007
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2008 Biochemical Society
2008
Clin Sci (Lond) (2008) 114 (7): 479–487.
Article history
Received:
August 02 2007
Revision Received:
September 24 2007
Accepted:
October 24 2007
Accepted Manuscript online:
October 24 2007
Citation
Manon V. Van Hecke, Jacqueline M. Dekker, Giel Nijpels, Tom Teerlink, Cornelis Jakobs, Ronald P. Stolk, Rob J. Heine, Lex M. Bouter, Bettine C.P. Polak, Coen D.A. Stehouwer; Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study. Clin Sci (Lond) 1 April 2008; 114 (7): 479–487. doi: https://doi.org/10.1042/CS20070275
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