الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
Diabetic nephropathy (DN) is a type of progressive kidney disease that occurs in people who have diabetes.
Diabetic nephropathy affects approximately one third of people with type 1 or type 2 diabetes mellitus. This will produce significant social and economic ramifications, particularly in the developing world. Tumor necrosis factor-α (TNF-α) is a proinflammatory cytokine that is essential in the regulation of inflammation, apoptosis and oxidative stress in the kidney. A high level of urinary TNF-α is correlated with renal injury and a disruption of the glomerular permeability barrier in patients with diabetes. This indicates that TNF-α is causally linked to renal injury in patients with diabetes and may be used as an early biomarker for the progression of DN.
This study was conducted on seventy patients (55 males and 15 females) with diabetes mellitus (divided into 35 diabetic patients with normoalbuminuria and 35 diabetic patients with low grade albuminuria). The patients were selected from the out patient’s clinic of Internal Medicine Department, El Mogamaa El Tibi Hospital in Tanta, Egypt, from March 2015 till March 2016.
Ten healthy individuals (7males and 3 females) were selected as a control group. The patients fulfilled the following criteria : age >18 years ,initial diagnosis of diabetes at >30 years of age, no signs of renal diseases, no history of cardiovascular diseases, including stroke, heart diseases and arteriosclerosis and no symptoms of acute inflammatory diseases.
Urine samples were collected during routine clinic visits of the patients and used for measurements of urinary marker TNF-α.
from this study, it appears that urinary TNF-α is positively correlated with diabetic nephropathy in most of the disease variables.
And it was higher in early stages of diabetic nephropathy (diabetic without albuminuria, and diabetic with low grade albuminuria) with both high specificity and sensitivity levels to the studied diabetic groups.
And this suggests the value of using this marker as an early predictor of diabetic nephropathy, together with the development of other biomarkers.