Reduced total plasma homocyst(e)ine in children and adolescents with type 1 diabetes

Abstract

Objectives: The objective was to investigate total plasma homocyst(e)ine (tHcy), methylenetetrahydrofolate reductase (MTHFR) genotype, and the contribution of diet to homocysteine values in children and adolescents with type 1 diabetes and a control group. Study design: A total of 78 children with type 1 diabetes and 59 members of an age- and sex-matched control group were recruited. Fasting samples were collected for tHcy, MTHFR genotype, serum vitamin B12, serum folate, red cell folate, and plasma creatinine. Food frequency questionnaires targeted intake of folate, vitamin B6, and vitamin B12. Results: Fasting tHcy was reduced in patients compared with the control group (4.7 vs 5.9 μmol/L, P <.001). Serum folate (P =.002), red cell folate(P <.001), and serum vitamin B12 (P =.005) were higher, and plasma creatinine was lower. A significant difference in tHcy values between patients and the control group persisted after correction was done for these factors (r = 0.1, P =.02). No difference was seen in the frequency of MTHFR polymorphisms. tHcy was not elevated in those patients with the 677TT or 677T/1298C genotypes, although red cell folate was significantly higher in members of the case (P =.01) and control groups (P =.05) with a 677 TT genotype. Dietary intake of folate correlated with serum folate (r = 0.4,P =.005). Conclusion: tHcy values are lower in children and adolescents with type 1 diabetes. Higher serum levels of folic acid and vitamin B12, reflecting differences in dietary intake between children with diabetes and members of a control group, partially account for this difference. (J Pediatr 2001;138: 888-93)