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Annals of Clinical Biochemistry

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Ann Clin Biochem 2008;45:476-480
doi:10.1258/acb.2007.007125
© 2008 Association for Clinical Biochemistry

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Original Articles

Homocysteine enhances LDL fatty acid peroxidation, promoting microalbuminuria in type 2 diabetes

Asma Kassab1, Thouraya Ajmi2, Manel Issaoui3, Larbi Chaeib4, Abdelhedi Miled1 and Mohamed Hammami3


1 Biochemistry Laboratory, CHU F Hached Sousse; 2 Epidemiology Unit, Medicine Faculty Sousse; 3 Biochemistry Department, Medicine Faculty Monastir; 4 Endocrinology Unit, CHU F Hached Sousse, Tunisia


Corresponding author: Dr Asma Kassab. Email: kassab.asma{at}laposte.net

Background: We aimed to establish the relationship between glycated haemoglobin (HbA1c), hypertension and microalbuminuria onset in type 2 diabetes. We also intended to ascertain the metabolic action of homocysteine on LDL fatty acids and on renal function.

Methods: The study was carried out on 200 patients with type 2 diabetes and 200 healthy subjects. HbA1c, apolipoprotein B (apo B) and microalbuminuria were measured using immunoturbidimetric methods. Cholesterol, peroxide, urea and uric acid were assayed using colorimetric methods. Creatinine clearance was calculated using the Cockroft-Gault equation. Homocysteine was measured by immunological fluorescence polarization. LDL fatty acids were quantified by gas chromatography.

Results: Creatinine and microalbuminuria significantly increased in type 2 diabetes when compared with controls. Microalbuminuria was significantly correlated with HbA1c and with the presence of high blood pressure. Homocysteinaemia significantly correlated with creatinine clearance in diabetes. Linoleic acid (C18:2{omega}6) did not differ between groups. C18:2{omega}6/C18:3{omega}3 ratio was three times higher in diabetics than in controls. Total saturated fatty acids, homocysteine, H2O2 and LDL-thiobarbituric reactive substances significantly increased in microalbuminuric when compared with normoalbuminuric diabetes. Total polyunsaturated fatty acids, arachidonic acid (C20:4{omega}6), LDL-cholesterol, apo B and creatinine clearance significantly decreased in microalbuminuric when compared with normoalbuminuric diabetes.

Conclusion: Microalbuminuria onset is associated with renal protein oxidation that is preceded by LDL fatty acid oxidation. The latter is initiated by H2O2 produced from an auto-oxidation of homocysteine and increased metabolism of arachidonic acid towards its pro-inflammatory eicosanoids. An oxidative stress state is the common ground of diffused vasculopathy.


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