Higher homocysteine and lower betaine increase the risk of microangiopathy in patients with diabetes mellitus carrying the GG genotype of PEMT G774C

Background Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This s...

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Published inDiabetes/metabolism research and reviews Vol. 29; no. 8; pp. 607 - 617
Main Authors Chen, Li, Chen, Yan-ming, Wang, Li-jun, Wei, Jun, Tan, Yao-zong, Zhou, Jing-ya, Yang, Yang, Chen, Yu-ming, Ling, Wen-hua, Zhu, Hui-lian
Format Journal Article
LanguageEnglish
Published England Blackwell Publishing Ltd 01.11.2013
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Abstract Background Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This study investigates the association of homocysteine, choline and betaine levels and phosphatidylethanolamine N‐methyltransferase (PEMT) G774C (rs12325817) genotypes with the risk of diabetes and its related microangiopathic complications. Methods Between January 2009 and June 2010, 184 diabetic patients and 188 non‐diabetic control subjects were enrolled in the hospital‐based case‐control study. Serum concentrations of betaine and choline were determined by high‐performance liquid chromatography (HPLC)–mass spectrometry. Serum concentrations of homocysteine were assayed using HPLC. PEMT gene mutations were detected by polymerase chain reaction and restriction fragment length polymorphism. Results After adjustment for potential confounders, serum total homocysteine had a significant dose‐dependent positive association, and serum choline had an inverse association with the risks of diabetes and its microangiopathic complications (both p < 0.001). Although serum betaine was not associated with the risk of diabetes, it had a significant inverse association with diabetic microangiopathy. Compared with GG genotype, the CC genotype of PEMT G774C was associated with a decreased risk of diabetes (OR 0.559, 95% CI 0.338, 0.926) and its microangiopathy (OR 0.452, 95% CI 0.218, 0.937). Conclusion The GG genotype of the PEMT G774C polymorphism, higher levels of serum homocysteine and lower levels of serum betaine are associated with an increased risk of microangiopathy in patients with diabetes. Copyright © 2013 John Wiley & Sons, Ltd.
AbstractList Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This study investigates the association of homocysteine, choline and betaine levels and phosphatidylethanolamine N-methyltransferase (PEMT) G774C (rs12325817) genotypes with the risk of diabetes and its related microangiopathic complications.BACKGROUNDDiabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This study investigates the association of homocysteine, choline and betaine levels and phosphatidylethanolamine N-methyltransferase (PEMT) G774C (rs12325817) genotypes with the risk of diabetes and its related microangiopathic complications.Between January 2009 and June 2010, 184 diabetic patients and 188 non-diabetic control subjects were enrolled in the hospital-based case-control study. Serum concentrations of betaine and choline were determined by high-performance liquid chromatography (HPLC)-mass spectrometry. Serum concentrations of homocysteine were assayed using HPLC. PEMT gene mutations were detected by polymerase chain reaction and restriction fragment length polymorphism.METHODSBetween January 2009 and June 2010, 184 diabetic patients and 188 non-diabetic control subjects were enrolled in the hospital-based case-control study. Serum concentrations of betaine and choline were determined by high-performance liquid chromatography (HPLC)-mass spectrometry. Serum concentrations of homocysteine were assayed using HPLC. PEMT gene mutations were detected by polymerase chain reaction and restriction fragment length polymorphism.After adjustment for potential confounders, serum total homocysteine had a significant dose-dependent positive association, and serum choline had an inverse association with the risks of diabetes and its microangiopathic complications (both p < 0.001). Although serum betaine was not associated with the risk of diabetes, it had a significant inverse association with diabetic microangiopathy. Compared with GG genotype, the CC genotype of PEMT G774C was associated with a decreased risk of diabetes (OR 0.559, 95% CI 0.338, 0.926) and its microangiopathy (OR 0.452, 95% CI 0.218, 0.937).RESULTSAfter adjustment for potential confounders, serum total homocysteine had a significant dose-dependent positive association, and serum choline had an inverse association with the risks of diabetes and its microangiopathic complications (both p < 0.001). Although serum betaine was not associated with the risk of diabetes, it had a significant inverse association with diabetic microangiopathy. Compared with GG genotype, the CC genotype of PEMT G774C was associated with a decreased risk of diabetes (OR 0.559, 95% CI 0.338, 0.926) and its microangiopathy (OR 0.452, 95% CI 0.218, 0.937).The GG genotype of the PEMT G774C polymorphism, higher levels of serum homocysteine and lower levels of serum betaine are associated with an increased risk of microangiopathy in patients with diabetes.CONCLUSIONThe GG genotype of the PEMT G774C polymorphism, higher levels of serum homocysteine and lower levels of serum betaine are associated with an increased risk of microangiopathy in patients with diabetes.
Background Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This study investigates the association of homocysteine, choline and betaine levels and phosphatidylethanolamine N-methyltransferase (PEMT) G774C (rs12325817) genotypes with the risk of diabetes and its related microangiopathic complications. Methods Between January 2009 and June 2010, 184 diabetic patients and 188 non-diabetic control subjects were enrolled in the hospital-based case-control study. Serum concentrations of betaine and choline were determined by high-performance liquid chromatography (HPLC)-mass spectrometry. Serum concentrations of homocysteine were assayed using HPLC. PEMT gene mutations were detected by polymerase chain reaction and restriction fragment length polymorphism. Results After adjustment for potential confounders, serum total homocysteine had a significant dose-dependent positive association, and serum choline had an inverse association with the risks of diabetes and its microangiopathic complications (both p<0.001). Although serum betaine was not associated with the risk of diabetes, it had a significant inverse association with diabetic microangiopathy. Compared with GG genotype, the CC genotype of PEMT G774C was associated with a decreased risk of diabetes (OR 0.559, 95% CI 0.338, 0.926) and its microangiopathy (OR 0.452, 95% CI 0.218, 0.937). Conclusion The GG genotype of the PEMT G774C polymorphism, higher levels of serum homocysteine and lower levels of serum betaine are associated with an increased risk of microangiopathy in patients with diabetes. Copyright © 2013 John Wiley & Sons, Ltd. [PUBLICATION ABSTRACT]
Background Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This study investigates the association of homocysteine, choline and betaine levels and phosphatidylethanolamine N‐methyltransferase (PEMT) G774C (rs12325817) genotypes with the risk of diabetes and its related microangiopathic complications. Methods Between January 2009 and June 2010, 184 diabetic patients and 188 non‐diabetic control subjects were enrolled in the hospital‐based case‐control study. Serum concentrations of betaine and choline were determined by high‐performance liquid chromatography (HPLC)–mass spectrometry. Serum concentrations of homocysteine were assayed using HPLC. PEMT gene mutations were detected by polymerase chain reaction and restriction fragment length polymorphism. Results After adjustment for potential confounders, serum total homocysteine had a significant dose‐dependent positive association, and serum choline had an inverse association with the risks of diabetes and its microangiopathic complications (both p < 0.001). Although serum betaine was not associated with the risk of diabetes, it had a significant inverse association with diabetic microangiopathy. Compared with GG genotype, the CC genotype of PEMT G774C was associated with a decreased risk of diabetes (OR 0.559, 95% CI 0.338, 0.926) and its microangiopathy (OR 0.452, 95% CI 0.218, 0.937). Conclusion The GG genotype of the PEMT G774C polymorphism, higher levels of serum homocysteine and lower levels of serum betaine are associated with an increased risk of microangiopathy in patients with diabetes. Copyright © 2013 John Wiley & Sons, Ltd.
Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and genetic polymorphisms in metabolic enzymes on the risk of microangiopathy in patients with diabetes is not well understood. This study investigates the association of homocysteine, choline and betaine levels and phosphatidylethanolamine N-methyltransferase (PEMT) G774C (rs12325817) genotypes with the risk of diabetes and its related microangiopathic complications. Between January 2009 and June 2010, 184 diabetic patients and 188 non-diabetic control subjects were enrolled in the hospital-based case-control study. Serum concentrations of betaine and choline were determined by high-performance liquid chromatography (HPLC)-mass spectrometry. Serum concentrations of homocysteine were assayed using HPLC. PEMT gene mutations were detected by polymerase chain reaction and restriction fragment length polymorphism. After adjustment for potential confounders, serum total homocysteine had a significant dose-dependent positive association, and serum choline had an inverse association with the risks of diabetes and its microangiopathic complications (both p < 0.001). Although serum betaine was not associated with the risk of diabetes, it had a significant inverse association with diabetic microangiopathy. Compared with GG genotype, the CC genotype of PEMT G774C was associated with a decreased risk of diabetes (OR 0.559, 95% CI 0.338, 0.926) and its microangiopathy (OR 0.452, 95% CI 0.218, 0.937). The GG genotype of the PEMT G774C polymorphism, higher levels of serum homocysteine and lower levels of serum betaine are associated with an increased risk of microangiopathy in patients with diabetes.
Author Wei, Jun
Zhou, Jing-ya
Chen, Yu-ming
Zhu, Hui-lian
Ling, Wen-hua
Chen, Yan-ming
Tan, Yao-zong
Chen, Li
Wang, Li-jun
Yang, Yang
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  email: Correspondence to: Hui-lian Zhu, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China., zhuhl@mail.sysu.edu.cn
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Keywords homocysteine
choline
microangiopathy
polymorphism
betaine
diabetes
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Barak AJ, Beckenhauer HC, Tuma DJ. Betaine, ethanol, and the liver: a review. Alcohol 1996; 13(4): 395-398.
Holm PI, Ueland PM, Kvalheim G, Lien EA. Determination of choline, betaine, and dimethylglycine in plasma by a high-throughput method based on normal-phase chromatography-tandem mass spectrometry. Clin Chem 2003; 49(2): 286-294.
Elias AN, Eng S. Homocysteine concentrations in patients with diabetes mellitus-relationship to microvascular and macrovascular disease. Diabetes Obes Metab 2005; 7(2): 117-121.
Melenovsky V, Stulc T, Kozich V, et al. Effect of folic acid on fenofibrate-induced elevation of homocysteine and cysteine. Am Heart J 2003; 146(1): 110.
Russo GT, Di Benedetto A, Giorda C, et al. Correlates of total homocysteine plasma concentration in type 2 diabetes. Eur J Clin Invest 2004; 34(3): 197-204.
Nolin TD, McMenamin ME, Himmelfarb J. Simultaneous determination of total homocysteine, cysteine, cysteinylglycine, and glutathione in human plasma by high-performance liquid chromatography: application to studies of oxidative stress. J Chromatogr B Analyt Technol Biomed Life Sci 2007; 852(1-2): 554-561.
Lever M, Slow S. The clinical significance of betaine, an osmolyte with a key role in methyl group metabolism. Clin Biochem 2010; 43(9): 732-744.
Fonseca V, Guba SC, Fink LM. Hyperhomocysteinemia and the endocrine system: implications for atherosclerosis and thrombosis. Endocr Rev 1999; 20(5): 738-759.
Stead LM, Brosnan JT, Brosnan ME, Vance DE, Jacobs RL. Is it time to reevaluate methyl balance in humans? Am J Clin Nutr 2006; 83(1): 5-10.
Wang FH, Liang YB, Peng XY, et al. Risk factors for diabetic retinopathy in a rural Chinese population with type 2 diabetes: the Handan eye study. Acta Ophthalmol 2011; 89(4): e336-343.
Xu X, Gammon M, Zeisel S, et al. Choline metabolism and risk of breast cancer in a population-based study. FASEB J 2008; 22: 2045.
Hajer GR, van der Graaf Y, Olijhoek JK, et al. Levels of homocysteine are increased in metabolic syndrome patients but are not associated with an increased cardiovascular risk, in contrast to patients without the metabolic syndrome. Heart 2007; 93: 216-220.
Holm PI, Hustad S, Ueland PM, et al. Modulation of the homocysteine-betaine relationship by methylenetetrahydrofolate Reductase 677 C-T genotypes and B-vitamin status in a large scale epidemiological study. J Clin Endocrinol Metab 2007; 92(4): 1535-1541.
Sun J, Xu Y, Zhu Y, Lu H. Genetic polymorphism of methylenetetrahydrofolate Reductase as a risk factor for diabetic nephropathy in Chinese type 2 diabetic patients. Diabetes Res Clin Pract 2004; 64(3): 185-190.
Basuni AA, Butterworth LA, Cooksley G, Locarnini S, Carman WF. An efficient extraction method from blood clots for studies requiring both host and viral DNA. J Viral Hepat 2000; 7(3): 241-243.
Wilcken DE, Wilcken B, Dudman NP, Tyrrell PA. Homocystinuria: the effects of betaine in the treatment of patients not responsive to pyridoxine. N Engl J Med 1983; 309(8): 448-453.
Ivanov A, Nash-Barboza S, Hinkis S, Caudill MA. Genetic variants in phosphatidylethanolamine N-methyltransferase and methylenetetrahydrofolate dehydrogenase influence biomarkers of choline metabolism when folate intake is restricted. J Am Diet Assoc 2009; 109(2): 313-318.
Jacques PF, Bostom AG, Wilson PW, et al. Determinants of plasma total homocysteine concentration in the frammingham offspring cohort. Am J Clin Nutr 2001; 73(3): 613-621.
Hoogeveen EK, Kostense PJ, Beks PJ, et al. Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease, especially in noninsulin- dependent diabetes mellitus: a population-based study. Arterioscler Thromb Vasc Biol 1998; 18(1): 133-138.
Rima Obeid, John Jung, Julia Falk, Wolfgang Herrmann, Jürgen Geisel. Serum vitamin B12 not reflecting vitamin B12 status in patients with type 2 diabetes. Biochimie 2012. pii: S0300-9084(12)00447-6.
Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362(12): 1090-1101.
Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339(4): 229-234.
Audelin MC, Genest J Jr. Homocysteine and cardiovascular disease in diabetes mellitus. Atherosclerosis 2001; 159(2): 497-511.
de Jager J, Kooy A, Lehert P, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ 2010; 340: c2181.
Buysschaert M, Dramais AS, Wallemacq PE, Hermans MP. Hyperhomocysteinemia in type 2 diabetes: relationship to macroangiopathy, nephropathy, and insulin resistance. Diabetes Care 2000; 23(12): 1816-1822.
Kerins DM, Koury MJ, Capdevila A, Rana S, Wagner C. Plasma S-adenosylhomocysteine is a more sensitive indicator of cardiovascular disease than plasma homocysteine. Am J Clin Nutr 2001; 74(6): 723-9.
Finkelstein JD, Martin JJ. Methionine metabolism in mammals. distribution of homocysteine between competing pathways. J Biol Chem 1984; 259(15): 9508-9513.
da Costa KA, Gaffney CE, Fischer LM, Zeisel SH. Choline deficiency in mice and humans is associated with increased plasma homocysteine concentration after a methionine load. Am J Clin Nutr 2005; 81(2): 440-444.
Durand P, Prost M, Loreau N, Lussier-Cacan S, Blache D. Impaired homocysteine metabolism and atherothrombotic disease. Lab Invest 2001; 81(5): 645-672.
Franken DG, Boers GH, Blom HJ, Trijbels FJ, Kloppenborg PW. Treatment of mild hyperhomocysteinemia in vascular disease patients. Arterioscler Thromb 1994; 14(3): 465-470.
Olthof MR, Verhoef P. Effects of betaine intake on plasma homocysteine concentrations and consequences for health. Curr Drug Metab 2005; 6(1): 15-22.
Al-Maskari MY, Waly MI, Ali A, Al-Shuaibi YS, Ouhtit A. Folate and vitamin B12 deficiency and hyperhomocysteinemia promote oxidative stress in adult type 2 diabetes. Nutrition 2012; 28(7-8): e23-26.
Satyanarayana A, Balakrishna N, Pitla S, Reddy PY, Mudili S. Status of B-vitamins and homocysteine in diabetic retinopathy: association with vitamin-B12 deficiency and hyperhomocysteinemia. PLoS One 2011; 6: e26747.
Lheto S, Rönnemaa T, Pyörälä K, Laakso M. Cardiovascular risk factors clustering with endogenous hyperinsulinaemia predict death from coronary heart disease in patients with type 2 diabetes. Diabetologia 2000; 43(2): 148-155.
Zeisel SH, Mar MH, Howe JC, Holden JM. Concentrations of choline-containing compounds and betaine in common foods. J Nutr 2003; 133(5): 1302-1307.
da Costa KA, Kozyreva OG, Song J, et al. Common genetic polymorphisms affect the human requirement for the nutrient choline. FASEB J 2006; 20(9): 1336-1344.
2004; 64
2012
2000; 23
2004; 27
1997; 42
2000; 43
2004; 24
2000; 7
1998; 339
2010; 362
2007; 92
2010; 340
1999; 20
2007; 93
2005; 81
1996; 13
2011; 6
2001; 24
2003; 133
2001; 81
2007; 852
2004; 11
1998; 18
2010; 43
2006; 20
2006; 83
2006; 45
2004; 34
1984; 259
2011; 94
2002; 326
2005; 7
1994; 14
2005; 6
2003; 49
2012; 28
2011; 89
2008; 22
2007; 21
2003; 146
2009; 109
1983; 309
2001; 159
2001; 73
2001; 74
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References_xml – reference: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2004; 27: S5-S10.
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– reference: Holm PI, Ueland PM, Kvalheim G, Lien EA. Determination of choline, betaine, and dimethylglycine in plasma by a high-throughput method based on normal-phase chromatography-tandem mass spectrometry. Clin Chem 2003; 49(2): 286-294.
– reference: Durand P, Prost M, Loreau N, Lussier-Cacan S, Blache D. Impaired homocysteine metabolism and atherothrombotic disease. Lab Invest 2001; 81(5): 645-672.
– reference: Franken DG, Boers GH, Blom HJ, Trijbels FJ, Kloppenborg PW. Treatment of mild hyperhomocysteinemia in vascular disease patients. Arterioscler Thromb 1994; 14(3): 465-470.
– reference: Meigs JB, Jacques PF, Selhub J, et al. Fasting plasma homocysteine levels in the insulin resistance syndrome: the Framingham offspring study. Diabetes Care 2001; 24(8): 1403-1410.
– reference: Kerins DM, Koury MJ, Capdevila A, Rana S, Wagner C. Plasma S-adenosylhomocysteine is a more sensitive indicator of cardiovascular disease than plasma homocysteine. Am J Clin Nutr 2001; 74(6): 723-9.
– reference: Finkelstein JD, Martin JJ. Methionine metabolism in mammals. distribution of homocysteine between competing pathways. J Biol Chem 1984; 259(15): 9508-9513.
– reference: Russo GT, Di Benedetto A, Giorda C, et al. Correlates of total homocysteine plasma concentration in type 2 diabetes. Eur J Clin Invest 2004; 34(3): 197-204.
– reference: Stead LM, Brosnan JT, Brosnan ME, Vance DE, Jacobs RL. Is it time to reevaluate methyl balance in humans? Am J Clin Nutr 2006; 83(1): 5-10.
– reference: Jacques PF, Bostom AG, Wilson PW, et al. Determinants of plasma total homocysteine concentration in the frammingham offspring cohort. Am J Clin Nutr 2001; 73(3): 613-621.
– reference: Fonseca V, Guba SC, Fink LM. Hyperhomocysteinemia and the endocrine system: implications for atherosclerosis and thrombosis. Endocr Rev 1999; 20(5): 738-759.
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– reference: Lever M, Slow S. The clinical significance of betaine, an osmolyte with a key role in methyl group metabolism. Clin Biochem 2010; 43(9): 732-744.
– reference: Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339(4): 229-234.
– reference: de Jager J, Kooy A, Lehert P, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ 2010; 340: c2181.
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– reference: Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362(12): 1090-1101.
– reference: Olthof MR, Verhoef P. Effects of betaine intake on plasma homocysteine concentrations and consequences for health. Curr Drug Metab 2005; 6(1): 15-22.
– reference: Rima Obeid, John Jung, Julia Falk, Wolfgang Herrmann, Jürgen Geisel. Serum vitamin B12 not reflecting vitamin B12 status in patients with type 2 diabetes. Biochimie 2012. pii: S0300-9084(12)00447-6.
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– reference: Audelin MC, Genest J Jr. Homocysteine and cardiovascular disease in diabetes mellitus. Atherosclerosis 2001; 159(2): 497-511.
– reference: Buysschaert M, Dramais AS, Wallemacq PE, Hermans MP. Hyperhomocysteinemia in type 2 diabetes: relationship to macroangiopathy, nephropathy, and insulin resistance. Diabetes Care 2000; 23(12): 1816-1822.
– reference: Zeisel SH, Mar MH, Howe JC, Holden JM. Concentrations of choline-containing compounds and betaine in common foods. J Nutr 2003; 133(5): 1302-1307.
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  publication-title: Diabetes Res Clin Pract
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  year: 1998
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  publication-title: Arterioscler Thromb Vasc Biol
– volume: 49
  start-page: 286
  issue: 2
  year: 2003
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– volume: 45
  start-page: 34
  year: 2006
  end-page: 37
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  year: 2010
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  start-page: S56
  year: 2004
  end-page: S64
  article-title: Role of hyperhomocysteinemia in endothelial dysfunction and atherothrombotic disease
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  issue: 8
  year: 2001
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  article-title: Fasting plasma homocysteine levels in the insulin resistance syndrome: the Framingham offspring study
  publication-title: Diabetes Care
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  year: 2010
  article-title: Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B‐12 deficiency: randomised placebo controlled trial
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  year: 2004
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  article-title: Betaine as a determinant of postmethionine load total plasma homocysteine before and after B‐vitamin supplementation
  publication-title: Arterioscler Thromb Vasc Biol
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  year: 2008
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  publication-title: FASEB J
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  issue: 2
  year: 2000
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  article-title: Cardiovascular risk factors clustering with endogenous hyperinsulinaemia predict death from coronary heart disease in patients with type 2 diabetes
  publication-title: Diabetologia
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  year: 2006
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  article-title: Is it time to reevaluate methyl balance in humans?
  publication-title: Am J Clin Nutr
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  issue: 1
  year: 2005
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  start-page: e336
  issue: 4
  year: 2011
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  publication-title: Acta Ophthalmol
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  issue: 5
  year: 2001
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  article-title: Impaired homocysteine metabolism and atherothrombotic disease
  publication-title: Lab Invest
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  issue: 1
  year: 2003
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  year: 2008
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Snippet Background Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl...
Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl donors and...
Background Diabetes represents one of the greatest medical and socioeconomic threats worldwide. The pathogenesis involved is complicated. The effect of methyl...
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StartPage 607
SubjectTerms Adult
Aged
Aged, 80 and over
betaine
Betaine - blood
Biomarkers - blood
Case-Control Studies
choline
diabetes
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - genetics
Diabetic Angiopathies - genetics
Female
Genotype
homocysteine
Homocysteine - blood
Humans
Male
microangiopathy
Middle Aged
Odds Ratio
Phosphatidylethanolamine N-Methyltransferase - genetics
polymorphism
Polymorphism, Restriction Fragment Length
Polymorphism, Single Nucleotide
Title Higher homocysteine and lower betaine increase the risk of microangiopathy in patients with diabetes mellitus carrying the GG genotype of PEMT G774C
URI https://api.istex.fr/ark:/67375/WNG-6VPTG1TR-0/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fdmrr.2432
https://www.ncbi.nlm.nih.gov/pubmed/23794489
https://www.proquest.com/docview/1456986710
https://www.proquest.com/docview/1459160689
Volume 29
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