Serum homocysteine levels are increased in women with gestational diabetes mellitus

Serum homocysteine (sHcy) has been found to be elevated in patients with type 2 diabetes mellitus, as well as in other clinical conditions associated with insulin resistance and/or vascular diseases. The aims of this study were to measure the relationship between sHcy with biohumoral markers of insulin resistance in pregnant women affected with gestational diabetes mellitus (GDM). We studied 2 groups of pregnant women categorized, after a 100-g, 3-hour oral glucose tolerance test (OGTT) as nondiabetic (n = 78) or affected with GDM (n = 15), by measuring sHcy, serum folate, albumin, vitamin B12, uric acid, and lipids. In both groups, peripheral insulin sensitivity was measured by using the OGTT-derived index of Matsuda and DeFronzo (ISIOGTT). Serum homocysteine was significantly higher in the group with GDM compared with nondiabetic women (5.88 ± 2.26 μmol/L v 4.45 ± 1.52 μmol/L; P = .003); was inversely related to serum folate (r = -.48; P = .0001), and was significantly related to serum albumin (r = .27; P = .009), 2-hour plasma glucose (r = .25; P = .01), as well as to serum uric acid (r = .23; P = .03). No relationship was observed between sHcy and serum vitamin B12, serum triglycerides, total, or high-density lipoprotein (HDL) cholesterol, mean blood pressure and ISIOGTT. Vitamin B12 was correlated with ISIOGTT (r = .36; P = .0005) and inversely with mean blood pressure (r = -.24; P = .02). GDM remained significantly associated with higher sHcy concentrations also after adjusting for age, serum folate, albumin, uric acid, ISIOGTT, and vitamin B12 (P = .006). In conclusion, we found that sHcy is significantly increased in women with GDM, independently of other confounding variables, is significantly related to 2-hour OGTT plasma glucose, and seems unrelated to insulin resistance in these subjects.