| Purpose:To examine the association of homocysteine(Hcy)with diabetic nephropathy(DN)and diabetic retinopathy(DR)in a representative United States population.Methods:This was a cross-sectional study using data from participants in the National Health and Nutrition Examination Survey(NHANES)2005-2006.Metrics including Hcy level,urinary albumin to creatinine ratio,estimated glomerular filtration rate(e GFR),and retinopathy grading were collected.Multiple logistic regression models were employed to assess the association of Hcy with DN and DR.Results:630 participants were included in this study.The Hcy level was significantly higher in those with DR and DN than those without DR and DN.Hcy was associated with an increased risk of DR(OR=2.260,95% CI: 1.212-4.216;p=0.014),but this association was non-significant in the fully adjusted model of DR(model II).Hcy was associated with an increased risk of DN(OR=1.31,95% CI: 1.18-1.46;P<0.001).In the fully adjusted model of DN(model II),compared to participants in quartiles 1of Hcy,the adjusted ORs for participants in quartiles 2-4 were 1.49(95% CI:0.52-4.26;P=0.426),3.81(95% CI: 1.35-10.73;P=0.015),and 14.08(95% CI:3.84-51.66;P=0.001),respectively.Conclusions:In diabetic patients,Hcy was associated with the risk of DR,but the association was attenuated after adjusting for confounders.In addition,Hcy was associated with increased risk of DN in a non-linear manner.In the future,Hcy can potentially be used as an early screening indicator for diabetic microvascular complications. |
