الفهرس 
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Abstract
Diabetes mellitus is a group of metabolic disorders
characterized by a chronic hyperglycemia condition resulting from
defects in insulin secretion, insulin action or both.
Type 2 diabetes is caused by a combination of genetic factors
related to insulin secretion , insulin resistance and environmental
factors such as obesity, overheating , lack of exercise and stress , as
well as aging .
The chronic hyperglycemia of diabetes is associated with long
term damage, dysfunction and failure of various organs like the
eyes , kidneys , nerves , heart and blood vessles.
Diabetic nephropathy is the kidney disease that occurs as a
result of diabetes, nephropathy is the leading cause of chronic renal
failure worldwide and is resposible for renal failure in about one
third who undergo dialysis.
TLR4 is an essential receptor for lipopolysachcarides
recognition ( LPS) recognition , it is a member of TLRs ,TLRs have
been considered to play a central role in the discrimination between
self and non self .To date more than 20 of these endogenus TLRs
fall into categories of releasesd intracellular proteins , extracellular
matrix components (ECM) , oxidatively modified lipids and other
soluble mediators .
TLR4 expressed largely on the cell surface where they
recognize molecules derived from microbes of many types. While the
intracellular receptors like TLR3, TLR7, TLR8 and TLR9 are
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intrinsically capable of detecting nuclic acids .to distinguish between
host and foreign nuclic acids , these TLRs act within the endosomal
compartment.
The present study aimed to asses the expression of TLR4 on
monocyte in patients with type 2 diabetes and as an early marker for
diabetec nephropathy in these patients and its correlation with other
biomarkers for diabetec nephropathy.
In the present study we have clinical evaluation , clinical data
as SBP , DBP and MBP and laboratory investigation as FBG , HbA1c
,urea , creatinine ,GFR and albumin / creatinine ratio and the level of
CD14 and TLR4 by flowcytometry.
Statistical comparison was done between different studied
patients groups and control groups.
The results of the present study showed that:
No statistically significant differences among the studied groups
regarding age, gender and weight.
As regards the clinical data:
There was statistically highly significant difference between the
studied groups as SBP, DBP and MBP.
As regards the diabetic data:
There was statistically highly significant difference between the
studied groups as regards duration, FBG and HbA1c (P < 0.001).
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As regards kidney functions:
There was statically highly significant difference between the
studied groups as regards urea , GFR and albumin /creatinine ratio
(P< 0.001 ) , and significantly difference between the studied groups
as regards creatinine ( P < 0.05 ) .
As the inflammatory markers:
The mean differences of CD14 were highly significant
between all the studied groups ( P < 0.001 ) .
The mean TLR4 levels were high in diabetic compared to
controls.
There were highly significant differences between the studied
groups as regarding TLR4 (P < 0.001).
As regards correlation between TLR4 and other studied parameters:
There were highly significant positive correlations between
TLR4 and each of SBP, DBP , MBP , FBG , HbA1c , ACR and
CD14, while there was significant correlation between TLR4 and
each of duration , urea and creatinine , highly significant negative
correlation between TLR4 and GFR and no significant correlation
between TLR4 and each of age and weight .