Association of Circulating Homocysteine Level with the Risk of Nephropathy in Type 2 Diabetes Mellitus: A Meta-Analysis

Abstract The objective of the study was to explore the association between homocysteine (Hcy) levels and the risk of type 2 diabetic nephropathy (T2DN). PubMed, Web of Science, Cochrane Library, and Embase databases were searched to collect literature on the association between Hcy levels and the risk of T2DN. The retrieval period was from the establishment of the database to September 10, 2024. Stata 15.0 statistical software was used for data analysis. Type II diabetes without nephropathy was considered the control group, and microalbuminuria and macroalbuminuria were included in the experimental group. Fourteen articles were included in this meta-analysis. The results of the meta-analysis showed that compared with the control group, the level of Hcy in the T2DN group with microalbuminuria [Weighted mean difference (WMD)=2.50, 95% confidence interval (CI): 1.49–3.51, p<0.001] and the group with macroalbuminuria (WMD=3.38, 95% CI: 1.95–4.82) was significantly increased. Compared with the T2DN microalbuminuria group, the Hcy level in the T2DN macroalbuminuria group was considerably higher (WMD=2.12, 95% CI: 0.80–3.44, p<0.001). High homocysteine levels were associated with an increased risk of T2DN (OR=1.36, 95% CI: 1.20–1.54, p<0.001). In conclusion, circulating Hcy levels are significantly associated with the severity of T2DN. In addition, there was a significant association between high Hcy levels and an increased risk of T2DN.