Elevated Plasma Level of Homocysteine is an Independent Risk Factor for Peripheral Neuropathy

Introduction: Elevated plasma level of homocysteine (eHcy) is associated with increased prevalence of peripheral neuropathy (PN) in diabetic patients. However, it is not known whether eHcy is an independent risk factor for the development of PN.
Methods: We retrospectively reviewed clinic and laboratory data of patients with PN, and patients with headaches serving as controls. The study consisted of two separate cohorts in two different settings. Setting-A was designed to address whether the isolated eHcy is relevant to PN and setting-B to analyze various risk factors in patients with PN.
Results: Fifty seven and 217 subjects with PN and 42 and 252 individuals with headache were included in the setting-A and setting-B, respectively. A significantly elevated level of homocysteine was observed in the patients with PN in both setting-A and setting-B (11.3±7.1 and 13.4±14.6 μmol/L, mean±SD) than in the patients with headaches (8.6±2.8 and 8.1±2.5, P=.02 and P=.02, respectively). In addition, significantly increased frequency of eHcy was observed in PN (21% and 38% in setting-A and setting-B) than that in headache controls (4.5% and 4.8%; P= .05 and P= .002, respectively).
Conclusion: eHcy may potentially act as an independent risk factor for the development of PN.