Serum homocysteine levels and diabetic neuropathy in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Aims/Introduction: Homocysteine (Hcys) is a thiol-containing amino acid formed by a demethylation methionine. Several studies showed a possible association between homocysteine and diabetic neuropathy in patients with type 2 diabetes. We performed a meta-analysis to evaluate the relationship between homocysteine and diabetic neuropathy. Materials and Methods: A systematic review and meta-analysis was performed to comprehensively evaluated the association between serum homocysteine levels and diabetic neuropathy in patients with type 2 diabetes mellitus. Literature updated to October 3, 2015 from Cochrane Library, MEDLINE, Web of Science, China Biology Medicine, and reference lists from relevant articles were identified. Data from eligible studies were pooled using meta-analysis. Results: A total of 784 individuals retrieved from five studies were finally included into the meta-analysis. Meta-analysis showed that there were obviously increased serum homocysteine levels in patients with diabetic neuropathy (WMD = 4.14 mu mol/L; 95% CI = 3.32 to 4.95, P < 0.00001). Sensitivity analysis showed that there was no obvious change in the pooled estimated. Conclusion: Homocysteine is involved in the development of diabetic neuropathy in type 2 diabetic patients and hyperhomocysteinemia is very likely to be associated with diabetic neuropathy. Further studies are needed to validate the relationships between hyperhomocysteinemia and diabetic neuropathy.