Journal
CLINICA CHIMICA ACTA
Volume 431, Issue -, Pages 206-210Publisher
ELSEVIER
DOI: 10.1016/j.cca.2014.02.007
Keywords
Homocysteine; Diabetic nephropathy; Risk; Meta-analysis
Categories
Funding
- National Basic Research Program of China 973 Program [2012CB517602, 2013CB530604]
- National Natural Science Foundation of China [81170635, 81270785]
- Research and innovation Project for College Graduates of Jiangsu Province, China [CXLX13_556]
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Background: It is well documented that hyperhomocysteinemia induces renal injury. However, the association between homocysteine level and type 2 diabetic nephropathy (T2DN) remains elusive. Methods: We evaluated the alteration of plasma level of homocysteine in T2DN patients with macroalbuminuria or microalbuminuria compared with type 2 diabetes mellitus (T2DM) controls without albuminuria by performing a meta-analysis. We searched the PubMed, Embase and Cochrane databases from January 1990 to October 2013 to identify studies that met predefined criteria. Results: Seven studies were included in this investigation.T2DN patients with macroalbuminuria demonstrated a significantly higher level of plasma homocysteine than T2DM without albuminuria (4 studies, random effects SMD: 1.66, 95% CI: 0.46 to 2.87, P = 0.007) and T2DN with microalbuminuria (3 studies, random effects SMD: 0.99, 95% CI: 0.62 to 1.36, P < 0.001). T2DN patients with microalbuminuria demonstrated significantly higher level of plasma homocysteine than T2DM without albuminuria (6 studies, random effects SMD: 1.29, 95%. CI: 0.59 to 2, P < 0.001). Exclusion of any single study had little impact on the pooled SMDs. No evidence of publication bias was observed. Conclusions: Our findings indicate that the status of plasma homocysteine is associated with both the risk and severity of nephropathy in T2DM. Frequent monitoring and early intervention should be recommended. (C) 2014 Elsevier B.V. All rights reserved.
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