Distribution of Homocysteine Levels in Type 2 Diabetes Patients and Its Association with Urine Albumin Creatinine Ratio: A Cross-sectional Study

Abstract

Introduction: Homocysteine (Hcy) is a metabolite whose level increases with age, in patients with Vitamin B12 deficiency, and is associated with increased risk of Cardiovascular Disease (CVD). Diabetes patients have been reported to have an increased prevalence of B12 deficiency and have a higher than baseline risk for CVD. Aim: To assess the distribution of serum Hcy levels in type 2 diabetes patients and to study its association with Urine Albumin:Creatinine Ratio (UACR). Materials and Methods: This cross-sectional study was conducted at the Diabetes Clinic, Department of Medicine (OPD), Gujarat Medical Education and Research Society (GMERS) Medical College and General Hospital, Gotri, Vadodara, India, from February 2025 to July 2025. Demographic data were collected along with testing for eGFR, serum Hcy and UACR. The study participant data were sub-grouped into Group 1 (n=55): participants with UACR <300 mg/g creatinine and Group 2 (n=25) UACR >300 mg/g creatinine. The distribution of Hcy was described as mean and Standard Deviation (SD). Pearson’s and Spearman’s correlations were used to assess the correlation of serum Hcy with FBS, eGFR and UACR. Participants were further sub-grouped based on UACR values, and Hcy levels were compared between these groups using a t-test. Results: The study cohort had 31 males and 49 females, with a mean age of 49.3±11.5 years, and the median duration of diabetes was two years. The serum Hcy level was found to be 16.68±8.01 μmol/L among type 2 diabetic patients. The subgroup of diabetic patients with UACR >300 mg/g creatinine had higher serum Hcy levels of 19.09±11.21 μmol/L, when compared to the sub-group with UACR <300 mg/g creatinine, in whom the distribution was 15.58±5.84 μmol/L. Conclusion: The distribution of serum Hcy among diabetic individuals was higher than the normal reference range. It is not influenced by age, gender or duration of diabetes. It increases further as renal damage gets established with UACR >300 mg/g creatinine.