Relationship between plasma homocysteine and ischemic stroke in type 2 diabetes patients: A case-control study

Objective: To investigate the relationship between plasma homocysteine (Hcy) and ischemic stroke in type 2 diabetes mellitus (T2DM) patients. Methods: We enrolled 149 T2DM patients, consisting of 65 cases of ischemic stroke and 84 controls. On the second day of hospitalization, fasting venous blood samples were collected to determine Hcy, HbAlc, blood lipids and other risk factors. The case-control study was conducted to identify the relationship between hyperhomocysteinemia and ischemic stroke. Results: Compared with that of the controls, plasma Hey level was significantly higher in T2DM patients with ischemic stroke [(24.4 ± 10. μmol/L vs. (16.3 ± 7.5) μmol/L, P<0.05]. The exposure rate differed significantly between the patients and the controls (χ² = 18.73, P<0.05). After adjusting age, OR was 4.81 and 95% CI was 2.21-11.45. The quartiles of Hcy were used to divide patients into four grades. OR increased from grade 2 to grade 4: 5.62, 12.96 and 14.73; the linear trend across the quartiles was significant (χ² = 24.44, P<0.001). The incidence of ischemic stroke increased with the increase of Hcy level. Conclusion: Hcy is a risk factor of ischemic stroke in type 2 diabetes patients. The incidence of stroke increases with the increase of plasma Hcy level.