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SA JOURNAL OF DIABETES & VASCULAR DISEASE

RESEARCH ARTICLE

VOLUME 14 NUMBER 1 • JULY 2017

35

writing. Ethical approval was obtained from the Tshwane University

of Technology Ethics Committee (Ref: 2010/09/004). A standard

informed consent form was signed by all participants.

A questionnaire was used to obtain information on demographic

characteristics, lifestyle, eating habits, health conditions such as

surgical operations, diabetes mellitus, previous arterial thrombosis,

previous pulmonary embolism, hyperlipidaemia, kidney problems,

obesity/overweight and heart failure. Cardiovascular disease was

one of the ailments that no participants reported to be suffering

from.

Fasting blood samples were collected from participants at the

Nobody Clinic in Ga-Mothapo. Subjects who had not fasted for at

least nine hours before sample collection and could not withdraw

medication for that period were excluded from the study.

Blood was collected by professional nurses. One 4.5-ml blood

sample was collected from each participant in a sodium fluoride

tube for glucose analysis, in a plain tube for triglycerides and

cholesterol estimation, and in an EDTA-anticoagulated tube for

homocysteine level assay.

The body weight of the participants wearing light clothing

without shoes was measured using a weight scale from Omron. The

height was measured without shoes in an upright position using

the Seca telescopic height-measuring rod. The BMI was calculated

using the formula: BMI = weight in kg/(height in m)

2

.

Blood pressure was measured using the Omron MI-5. Blood

glucose, triglyceride and cholesterol levels were measured using

the ILab 300 Plus Chemistry System from Beckman Coulter.

Homocysteine was estimated using the Beckman Coulter Synchron

system analyser. Enzymatic methods were used for all biochemical

parameters.

The diagnostic criteria used for the parameters were set as

follows: hyperhomocysteinaemia = blood homocysteine > 15 µmol/l,

hyperglycaemia=bloodglucose>7.0mmol/l,hypercholesterolaemia

= blood cholesterol > 5.7 mmo/l, hypertriglyceridaemia = blood

triglyceride > 2.26 mmol/l, obesity = BMI > 30 kg/m

2

, systolic blood

pressure > 140 mmHg = hypersystolic blood pressure, and diastolic

blood pressure > 90 mmHg = hyperdiastolic.

The collected data were analysed with Statistical Package for

Social Science (SPSS) version 18. The results were expressed in

percentages of

p

-values for association. A

p

-value of 0.05 was

regarded as statistically significant.

Results

The study consisted of 382 participants. The mean age of the study

participants was 38.45 years. The mean values for the studied

parameters were as follows: homocysteine 9.44 µmol/l, glucose

5.42 mmol/l, systolic blood pressure 125.65 mmHg, diastolic blood

pressure 81.06 mmHg, cholesterol 4.18 mmol/l, triglycerides 1.22

mmol/l and BMI 26.80 kg/m

2

(Table 1).

The associations of hyperhomocysteinaemia with hyper-

glycaemia (

p

= 0.175), hypertriglyceridaemia (

p

= 0.442) and

hypercholesterolaemia (

p

= 0.480) were statistically insignificant.

The association of hyperhomocysteinaemia with obesity was

found to be partially significant (

p

= 0.080). The associations

of hyperhomocysteinaemia with hypersystolic (

p

= 0.002) and

hyperdiastolic (

p

= 0.033) blood pressures were statistically

significant.

Of the 45 hyperglycaemic participants, three were also

hyperhomocysteinaemic, constituting about 6.7%. Of the 39

hypertriglyceridaemic participants, three were also hyperhomo-

cysteinaemic, constituting about 7.7%. Of the 38 hypercholes-

terolaemic participants, five were also hyperhomocysteinaemic,

constituting about 13.1%. Of the 72 participants with high systolic

blood pressure, 11 were also hyperhomocysteinaemic, constitut-

ing about 15.3%. Of the 84 participants with high diastolic blood

pressure, 16 were also hyperhomocysteinaemic, constituting about

19.0%. Of the 95 obese participants, 10 were also hyperhomo-

cysteinaemic, constituting about 10.5%.

Discussion

We estimated homocysteine levels in 45 hyperglycaemic subjects

for evaluation of association and found no statistical significance

(

p

= 0.175) (Table 2). Three hyperglycaemic subjects (6.7%) were

hyperhomocysteinaemic (Table 3). Different findings about the

relationship have been reported above.

Vayá

et al

., in their study of the relationship between

homocysteine and hyperglycaemia, found a partial association.

15

Elias and Eng, and Shaikh

et al

. reported that homocysteine levels

can be low or elevated in diabetes mellitus.

1,13

These findings and

ours are contrary to the findings of Mishra

et al

.

2

and Akali

et al

.

12

who found high homocysteine levels in diabetic patients. They

found high levels of homocysteine to be a strong risk factor in

diabetic patients. This was supported by the findings of Shaikh

et

al

. and Schalinske.

1,14

Shaikh

et al

. found more than half of their diabetic participants

had elevated homocysteine levels.

1

The discrepancy with our results

could have been attributable to the influence on homocysteine

of insulin concentrations, therapy with insulin and medication.

12

Control of these confounding factors in our study may have

improved the level of association.

Table 1.

Characteristics of the participants

Variable

Mean ± SD

Age (years)

38.45 ± 17.283

Homocysteine (μmol/l)

9.44 ± 4.13

Glucose (mmol/l)

5.42 ± 2.555

Systolic blood pressure (mmHg)

125.65 ± 19.164

Diastolic blood pressure (mmHg)

81.06 ± 11.351

Cholesterol (mmol/l)

4.18 ± 1.396

Triglycerides (mmol/l)

1.22 (0.83–1.68)

Body mass index (kg/m

2

)

26.80 ± 6.20

Table 2.

P

-values for significance of association

Homocysteinaemia Metabolic disorder

p

-value

n

= 45

Hyperglycaemia (

n

= 45)

0.175

n

= 39

Hypertriglyceridaemia (

n

= 39)

0.442

n

= 38

Hypercholesterolaemia (

n

= 38)

0.480

n

= 72

Systolic blood pressure (

n

= 72)

0.002

n

= 84

Diastolic blood pressure (

n

= 84)

0.033

n

= 95

Obesity (

n

= 95)

0.080

95% confidence interval and

p

= 0.05 level of significance.