인슐린비의존형 노인 당뇨병환자의 엽산섭취와 혈장 호모시스테인 수준

Folate Intakes and Plasma Homocysteine Levels in the Elderly Patients with NIDDM

Hyperhomocysteinemia has been shown to be associated with increased risks for macrovascular angiopathy. The present study was conducted to document the relationship between plasma homocysteine levels and the presence of macrovascular angiopath in patients with Type II diabetes mellitus. Plasma total homocysteine was determined by a HPLC-fluorescence detection method in a total of 238 subjects, 127 diabetic patients and 111 control. Dietary information including folate intake was assessed by a 24-hour recall in a total 113 subjects, 70 diabetic patients and 43 control. Folate intake was significantly lower inn patients with diabetes mellitus than that in the control. The lowered folate intake in the diabetic patients was mainly due to reduced intakes of fruits and vegetables. The average plasma homocysteine level of patients with MA was 14.2$\mu$㏖/L, which was significantly higher than that of either the patients without MA(11.4$\mu$㏖/L) or the control(11.5$\mu$㏖/L). Twenty five percent of the diabetic patients were positively correlated with age (r=0.20), body weight (r=0.28), body mass index (r=0.28), body mass index (r=0.18), diastolic blood pressure (r=0.20), and total cholesterol (r=0.14). cigarette smokers had significantly higher levels of plasma homocysteine than the non-smokers. Further prospective studies are needed to investigate whether folate or other B vitamin supplementation could be beneficial for the prevention of hyperhomocysteinemia or macrovascular angiopathy in the diabetic patients.