Association of serum homocysteine and lipid profile with macroangiopathy in patients with type 2 diabetes mellitus in an Indian population

Diabetes mellitus constitutes a major global health burden, with prevalence escalating rapidly in developing nations, particularly India. Emerging evidence implicates hyperhomocysteinemia in the pathogenesis of vascular complications among diabetic patients. This hospital-based cross-sectional study was conducted at Shree Krishna Hospital, Karamsad, India, between November 2017 and April 2019 to elucidate the association between serum homocysteine, lipid profile, and macroangiopathy in type 2 diabetes mellitus. The study included 100 patients: 50 with documented macroangiopathy and 50 without macroangiopathy. Fasting blood samples were analyzed for glucose, HbA1c, lipid profile, and homocysteine. Serum homocysteine was markedly elevated in patients with macroangiopathy compared to those without (median: 29.26 vs. 13.20 μmol/L; p < 0.001). Homocysteine showed significant positive correlation with triglycerides (TG) (r = 0.225, p = 0.025) and negative correlation with HDL-C (r = − 0.204, p = 0.042). Homocysteine levels were significantly higher in males ( p = 0.012) and in patients not receiving vitamin B12 supplementation ( p < 0.001). Logistic regression identified homocysteine as the sole independent predictor of macroangiopathy among the investigated parameters (OR 1.296; 95% CI 1.154–1.455; p < 0.001). Elevated serum homocysteine demonstrates a significant association with macroangiopathy in patients with type 2 diabetes mellitus, suggesting its potential utility as a risk marker for vascular complications. However, the cross-sectional nature of this investigation precludes causal inference. Prospective longitudinal studies are warranted to validate these findings and establish the clinical utility of homocysteine screening in diabetic populations.