BES2002 Poster Presentations Diabetes & Metabolism (35 abstracts)
Increased red cell folate subsequent to folic acid supplementation in type II diabetes results in a reduction in microalbumin excretion but an increased atherogenic lipid profile
DF Child 1 , PR Hudson 2 , H Jones 1 , GK Davies 2 , P De 1 , JN Harvey 1 & CP Williams 2
1Diabetic Medicine,Maelor Hospital,Wrexham,UK; 2Chemical Pathology,Maelor Hospital,Wrexham,UK.
Plasma homocysteine is now regarded as a graded risk factor for vascular disease comparable to smoking, high cholesterol and raised blood pressure. In diabetes homocysteine values have correlated with microalbuminuria and are thought to contribute to vascular damage. Folic acid is an essential co-factor for homocysteine metabolism and folic acid supplementation has been shown to reduce plasma homocysteine by about 30%.
In this study patients with Type II diabetes were treated with folic acid 10mg daily for 3 months to determine whether it would have any effect on previously documented microalbuminuria.
27 patients were recruited with local ethical committee approval: 26 males and 1 female (no sex bias intended). Their age range was 44-68 years, mean 59 years. 25 patients were taking antihypertensive medication, of whom 18 were taking ACE inhibitors and 9 were taking a statin for hyperlipidaemia. At the beginning of the study and on completion, early morning urine samples were collected for albumin/creatinine ratio (a measure of microalbumin excretion) and fasting blood samples for total plasma homocysteine, total glutathione, lipids, red cell folate and HbA1c.
Mean plasma homocysteine was 12.7 micromoles per litre before and 10.9 after treatment (paired t-test, p = 0.002). Albumin/creatinine ratio decreased with increasing red cell folate (regression analysis, p = 0.002). HbA1c decreased with increasing plasma glutathione concentration (regression analysis, p = 0.015). Mean HDL cholesterol was 1.13 millimoles per litre before and 1.04 after treatment (paired t-test, p = 0.006) and mean triglyceride was 2.85 millimoles per litre before and 3.26 after treatment (p = 0.04).
Folate supplementation appears to improve microalbumin excretion in diabetic subjects but also to have adverse effects on lipids.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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