Homocysteine, Cortisol, Diabetes Mellitus, and Psychopathology

Abstract

Objective . This study investigates the association of homocysteine and cortisol with psychological factors in type 2 diabetic patients. Method . Homocysteine, cortisol, and psychological variables were analyzed from 131 diabetic patients. Psychological factors were assessed with the Eysenck Personality Questionnaire (EPQ), Hostility and Direction of Hostility Questionnaire (HDHQ), the Symptom Checklist 90-R (SCL 90-R), the Zung Self-Rating Depression Scale (ZDRS), and the Maudsley O-C Inventory Questionnaire (MOCI). Blood samples were taken by measuring homocysteine and cortisol in both subgroups during the initial phase of the study ( T 0). One year later ( T 1), the uncontrolled diabetic patients were reevaluated with the use of the same psychometric instruments and with an identical blood analysis. Results . The relation of psychoticism and homocysteine is positive among controlled diabetic patients ( P value =<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mn>0.006</mml:mn><mml:mo>&lt;</mml:mo><mml:mn>0.05</mml:mn><mml:mo stretchy="false">)</mml:mo></mml:math>and negative among uncontrolled ones ( P value = 0.137). Higher values of cortisol correspond to lower scores on extraversion subscale<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mi>r</mml:mi></mml:mrow><mml:mrow><mml:mi>p</mml:mi></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn>0.223</mml:mn></mml:math>, P value = 0.010). Controlled diabetic patients showed a statistically significant negative relationship between homocysteine and the act-out hostility subscale<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mi>r</mml:mi></mml:mrow><mml:mrow><mml:mtext>sp</mml:mtext></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn>0.247</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.023</mml:mn><mml:mo stretchy="false">)</mml:mo></mml:math>. There is a statistically significant relationship between homocysteine and somatization<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mi>r</mml:mi></mml:mrow><mml:mrow><mml:mtext>sp</mml:mtext></mml:mrow></mml:msub><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn>0.220</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.043</mml:mn><mml:mo stretchy="false">)</mml:mo></mml:math>. Conclusions . These findings support the notion that homocysteine and cortisol are related to trait and state psychological factors in patients with diabetes mellitus type 2.