Lecithin: Cholesterol Acyltransferase Activity and Homocysteine Levels are Better Associated with Lipid Profile Indices Compared to Glycemic Control Indices in Patients with Diabetes Mellitus

Aims: Homocysteine (Hcy) level, LCAT activity, and HDL-C concentration and oxidative/anti-oxidative capacities are well-established factors in determining cardiovascular disease risk in Type 2 diabetes mellitus. However, the association between these factors and lipid profile and glycemic control variables remains to be unveiled. We aimed to assess accuracy of LCAT activity and Hcy for dyslipidemia and poor glycemic control screening in patients with type 2 diabetes mellitus.

Study Design: This case control study was conducted in Vali-Asr hospital affiliated with Tehran University of Medical Sciences.

Methodology: We quantified FBS, HDL-C, HbA1c, Hcy, LCAT activity and other lipid profiles markersin a total of 41 patients with type 2 diabetes mellitus along with 41 matched healthy subjects.

Results: Linear regression and correlation analysis revealed that Hcy had a positive correlation with LCAT activity only in HDL levels above 40 mg/dl. Receiver operating characteristics (ROC) curves testing LCAT activity in prediction of hyperhomocysteinemia as the state variable for both control subjects and patients, showed the one for patients with diabetes being more shifted up and to the left than for control subjects. In addition, both Hcy and LCAT activity predicted lipid profile variables more precisely than glycemic control variables.

Conclusion: LCAT activity could be considered as one of the factors predicting hyperhomocysteinemia and therefore indirectly associated with cardiovascular events and it is more specific and sensitive in patients with diabetes compared to control subjects. However neither Hcy and nor LCAT activity, are able to predict diabetes and/or diabetes associated oxidative stress. These factors might be more associated with diabetes related dyslipidemia.