الفهرس 
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Abstract
Osteoprotegerin (OPG) is a soluble member of the TNF–receptor superfamily and act as decoy receptor for both the receptor activator of nuclear factor-B ligand (RANK–L) and the TNF–related apoptosis inducing ligand (TRAIL). It is thought to be closely related to vascular pathology in diabetic population. The aim of the current study was to study circulatory level of serum Osteoprotegerin patients with type 2 diabetes mellitus and any possible association with the presence and/or severity of peripheral arterial disease diagnosed by Doppler ultrasonography.
For that purpose we enrolled 180 subjects in the study and those were divided equally into three groups; group I consisted of 60 diabetic patients with evidence of peripheral arterial disease, group II consisted of 60 diabetic patients without peripheral arterial disease and group III consisted of 60 healthy age and gender matched subjects.
The differences between all groups were significant as regards to HOMA-IR level. The differences were also significant between the all three groups according to lipid profile except for triglycerides which were significant only when comparing three groups but not group I and group II together. With respect to osteoprotegrin level, group I was significantly higher than group II which was significantly higher than group III. The mean level was 0.32 ± 0.23, 0.14 ± 0.05 and 0.05 ± 0.05 for group I, II and III respectively. The results of group I as regards to Doppler were as follows; percentage of monophasic, biphasic and triphasic was 33.3%, 60.0% and 0.0% for right foot respectively while for left foot the percentage was 23.3%, 66.7% and 6.7% respectively.
Nine parameters were significantly related to osteoprotegrin when univariate analysis was used namely, age, duration of illness, BMI, blood pressure, monofilament score, VPT score, average ABI, uric acid and LDL. However, only three parameter were significant when multivariate analysis was used which were age, duration of illness and average ABI.
The study had the following conclusions:
1. OPG level is closely related to the presence of peripheral arterial disease and it may have the merit of being an early marker for the disease.
2. OPG level may have a correlation with duration of diabetes, age and ankle brachial index (ABI).
3. The relation between ABI and OPG level may reflect a role of the later as a marker of not only the presence but also the severity of PAD.