Table A2.

Metabolic syndrome and type 2 diabetes mellitus.

With a comparable HCys level, oxidative stress is stronger than in controls [61], directly detectable in myocardial fibrils (bypass surgery): H2O2 production ↑, antioxidants ↓ [170]. Metformin therapy inhibits intestinal absorption of vitamin B12 and folic acid [171].

Plasma HCys level as in controls, but higher if nephropathy is present. HCys is more strongly associated with atherosclerosis and its consequences than in non-diabetes controls [172]. Primarily preventive, folic acid supplementation lowers HCys and insulin levels, reduces insulin resistance, normalizes glucose homeostasis and atherogenic plasma lipid profile [173]. Metformin therapy lowers B12 levels, increases HCys levels and intensifies diabetic neuropathy [174].