Correlation between elevated serum homocysteine level and the development of diabetic peripheral neuropathy: a comparative study and meta-analysis

Background: This study aims to explore the correlations between serum homocysteine (Hcy) levels and diabetic peripheral neuropathy (DPN), which is further verified by meta-analysis. Methods: From June 2012 to June 2014, 188 type 2 diabetes mellitus (T2DM) patients admitted to Department of Endocrinology in Yantai Zhifu Hospital were enrolled in this study. T2DM patients were divided into simple diabetes mellitus group (SDM group) (n = 101) and DPN group (n = 87) based on Electromyography (EMG). Fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin (HbAlc), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and serum creatinine (Scr) level were detected. Data analysis was conducted by SPSS 18.0 software. Meta-analysis utilized R 3.1.0 software. Results: The diabetic duration, HbAlc and Hcy level of patients in DPN group were significantly higher than those in SDM group; the difference was statistically significant (P < 0.05). Pearson correlation analysis showed that serum Hcy level was positively correlated with disease duration, HbAlc, while no significant correlation was found between serum Hcy level with other indexes such as age, gender, BMI, FBG, TG, TC, LDL-C, HDL-C, SBP, DBP, etc. (P > 0.05). Logistic regression analysis results indicated that Hcy, course of disease and HbAlc had a positive correlation with DNP, and they were the risk factors of DPN. The result of our meta-analysis showed that serum Hcy level in DPN patients was significantly higher than that in healthy controls. Conclusion: Serum Hcy level is significantly related to the occurrence of DPN and the detection of serum Hcy level has important clinical significance in the prevention and treatment of DPN.