Saturday, September 10, 2011

Emedinews: Dr Good Dr Bad:A patient with diabetic nephropathy was found to have a high homocysteine levels.

Situation: A patient with diabetic nephropathy was found to have a high homocysteine levels.
Dr Bad: Homocysteine has no correlation with nephropathy.
Dr Good: You should control your homocysteine levels.
Lesson: Results of a nested case–control study suggest that hyperhomocysteinemia has an etiologic role in the pathogenesis of diabetic nephropathy. In the study, baseline plasma homocysteine concentrations and mean HbA1c levels during follow–up were significantly higher in patients who developed microalbuminuria than in those who remained normoalbuminuric. Multivariate logistic regression analysis showed that baseline plasma homocysteine level and mean HbA1c were independent predictors of microalbuminuria in type 2 diabetes (Korean Diabetes J 2010 June; 34(3): 200–206).

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