الفهرس 
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Abstract
Diabetic nephropathy is the major cause of end-stage renal disease. Diabetic nephropathy is characterized by hypertension, progressive albuminuria, and decline in glomerular filtration rate (GFR) leading to ESRD. The first step in the screening and diagnosis of diabetic nephropathy is to measure albumin in urine sample.
In this study, we aimed to evaluate serum Zinc levels in patients with type2 diabetes as a marker for diabetic nephropathy.
This study was conducted on a 100 Subjects ( 25 controls,25 diabetic without albuminuria,25 diabetic with albuminuria and 25 non diabetic patients with CKD) . Patients were selected from out patients and in patient clinics of nephrology Department, Madint Nasr Police Hospital-Egypt during the period from March, 2016 to december 2016. Informed consent was obtained from all participants who were be fully informed about the study.
Subjects were divided into 4 groups:
group 1): 25 controls
group 2): 25 type 2 diabetic patients, without albuminuria.
group 3): 25 type 2 diabetes with albuminuria.
Group4): 25 no diabetic with CKD.
Exclusion criteria:
- Hypertensive patients
- Patients showed evidence of liver cirrhosis or other liver diseases or HCV antibody positive (steatosis and steatohepatitis are not excluded)
- Pregnant women
All subjects were subjected to the followings:
Full history taking.
Complete clinical examination and measurement of body mass index.
Investigations:-
Routin investigations:
1. Complete urine analysis.
2. C.B.C.
3. Blood glucose level (fasting, 2hours post prandial) and HbA1c.
4. Plasma lipid profile( T.cholestrol& T.Gs)
5. The liver function test(SGOT,SPOT,P.T, Serum albumin, T.s. bilirubin)
6. Renal function test (urea and creatinine).
7. Urinary albumin/creatinine ratio
8. Abdominal ultrasonography for kidney, liver, spleen
Special investigations: - Measurement of serum Zinc.
Results showed:
- Decrease serum Zinc level more significant in DM patients with albuminuria than other patients and controls.
- Higher lipid profile (cholesterol, TGs) levels with DM and CKD patients in comparison to the control group, and in DM with Albuminuria group higher than other groups.
- Increased HbA1c, FBG, and 2HPP in DM with albuminuria patients than DM without albuminuria.
- Increased urea and creatinine and urinary Alb /creat ratio in DM with albuminuria patients compared to DM without albuminuriauria group.
- Negative correlation between (urea, creatinine and urinary Alb/creat ratio) and serum Zinc in DM with proteinuria.
- Negative correlation between serum Zinc level and cholesterol, triglycerides levels in DM with albuminuria .
- Negative correlation also seen between serum zinc level and albumin \creat ratio in patients with CKD.