Follow-Up of Homocysteine, Folate and Vitamin B12 in Children and Young Adults with Type 1 Diabetes Mellitus

It is far from clear whether hyperhomocysteinemia (HH(e)), when present, is a preexisting marker for diabetic patients predisposed to vascular complications or an acquired condition that may change over time. To try to clarify this question we examined in two different moments, after 2 years or more, a group of 46 diabetic children and young adults. Age at entry ranged between 4.25 and 28.5 years, mean duration of disease was 10.9 ±4.6 years and mean HbA1c value 8.3±1.6%. In all patients in both examinations we assessed basal homocysteine (H(e)), folate, vitamin B6 and vitamin B12 levels. Total, free + protein-bound, plasma H(e) level were measured by HPLC. Results: The 3 patients with hyperhomocysteinemia at first control showed HH(e) also at second control without developing new complications. At second xamination 4 other patients (9%), that had at entry normal H(e) values, howed hyperhomocysteinemia. Asignificant positive correlation was found between levels detected at first and second examination, of H(e) (p<0.0001), folate (p<0.0001), vitaminB12 (p<0.001) and HbA1c (p=0.02). Both at first and second examination a significant negative relationship between H(e) and folate levels (p=0.002 and p<0.0001 respectively) was found. Conclusions: Although in most cases the genetic imprinting seems to influence H(e) and vitamin levels, in some cases hyperhomocysteinemia may appear over time. While a strict relationship between H(e) and folate was present all the times, the relationship between hyperhomocysteinemia and vascular complications in our patients was uncertain