Relation between total homocysteine levels and beer intake in patients with diabetes mellitus type 2

Background/Aim: The evaluation of the significance of hyperhomocysteinemia in type 2 diabetes is further complicated by the multiple ways of considering impaired renal function, vitamin status, and lifestyle. The aim of our study was to investigate the relation between macro- and micronutrient intakes and homocysteine levels in a population having diabetes type 2. Methods: A total of 155 patients with diabetes mellitus type 2 attending our Diabetes Service (90 females and 65 males) were enrolled in a consecutive way. All patients underwent determination of fasting blood homocysteine, glycated hemoglobin, glucose, vitamin B-12, and folate levels. Microalbuminuria was evaluated on the basis of a 24-hour urine. The patients were instructed to keep 3-day written food records incorporating the use of food scales and models to enhance portion size accuracy. Alcohol drinking, physical activity, and smoking habits were also registered. Results: The mean homocysteine levels were 10.5 +/- 4.3 mumol/l. The mean glucose and Hb A(lc) levels were 9.5 +/- 3 mmol/l and 7.8 +/- 1.4%, respectively. The vitamin status was normal: 592.6 +/- 522 pg/ml vitamin B-12 and 10.5 +/- 5.5 ng/ml folic acid. Mean microalbuminuria was 81.7 +/- 238 mg/day. The calorie intakes were normal (carbohydrates 43%, proteins 23.8%, and lipids 33.1%). A decrease in daily intakes of vitamins (A, B-1, D, and E) and trace elements (Zn, Mg, Se, and Ca) was detected. High daily intakes were detected for protein, P, and vitamins C, B-12, K and P 29.7% of the patients drank beer and 18% other alcoholic beverages. 11.7% of the patients smoked, and 77.7% maintained daily physical activity (mean/day 25.7 +/- 20.9 min). Only protein (g/day; r = 0.5; 0 < 0.005) and beer (ml/day; r = -0.46; p < 0.05) correlated with the total homocysteine levels. The daily intakes of vitamin B-12 and folic acid were inversely correlated with the total homocysteine levels: r = -0.29; p < 0.05 and (r = -0.12; p < 0.05), respectively. Physical activity and smoking habits were not correlated. In the multivariate analysis with a dependent variable (total homocysteine) adjusted for age, sex, microalbuminuria, and, nutrient intakes (proteins, folic acid, and vitamin B-12) and beer remained in the model. Conclusion: The present study-shows that protein intake and beer could modify the levels of total homocysteine in patients with diabetes type 2. Copyright (C) 2003 S. Karger AG, Basel.