Association between serum homocysteine and markers of insulin resistance

Abstract

OBJECTIVE: To investigate the association between serum homocysteine and markers of insulin resistance in a Sri Lankan population. Similar studies conducted in other ethnic groups have shown conflicting results. METHODS: 177 apparently healthy volunteers (91 men and 86 women) aged 35-65 years were randomly selected from residents in the Ragama MOH area. Anthropometric indices and blood pressure were measured and information on diet, lifestyle factors and medical history were recorded. Fasting plasma glucose and serum levels of homocysteine, insulin, creatinine, folate and lipid profiles were determined using standard protocols. RESULTS: Mean fasting serum homocysteine levels were higher in males compared to females (14.67 (imol/1 ± 6.02 Vs.10.16 u.mol/1 ± 4.28, p<Q.001) and were positively associated with age (p< 0.01 in both sexes). In males, homocysteine levels were negatively related to serum insulin (r= -0.397, p<0.001) and BMI (r= -0.244, p <0.02) and positively related to serum creatinine (r=0.235, ;?<0.02). In females, there was a positive relationship between homocysteine and systolic blood pressure (r= 0.239, jp<0.02) but there was no significant correlation with serum insulin. In both sexes, serum homocysteine levels strongly correlated with serum folate (r= -0.412, ^<0.00i). Stepwise regression analysis confirmed the relationships between homocysteine and folate (pO.OOl in both sexes), insulin (p=Q.Q26 in males) and creatinine (p=0.036 in males). CONCLUSIONS: Gender specific differences exist in the association of homocysteine with markers of insulin resistance. The inverse relationship observed between homocysteine and insulin in males may indicate a role of insulin in homocysteine metabolism.