الفهرس 
Chapter I: Diabetes mellitusOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is a complex metabolic disease characterized by chronic hyperglycemia resulting in complications affecting the peripheral nerves, kidneys, eyes, micro and macrovascular structures. Diabetic nephropathy (DN) is one of the microvascular complications of diabetes mellitus and is an important cause of end-stage renal disease, with high morbidity and mortality. The risk of progression of diabetic nephropathy has improved over the last several decades, largely due to vigorous glycemic control, more blood pressure reduction and the use of angiotensin converting enzyme inhibitors.
YKL-40 is an inflammatory glycoprotein. It is a 40-kDa heparin- and chitin-binding lectin and a member of the mammalian chitinase-like protein family, known as cartilage glycoprotein-39 or chitinase-3-like protein 1. YKL-40 is secreted by a variety of human cells.
Many studies found the relation between ACR in urine sample and with YKL-40 serum level.
The general objective of the present study was to reduce chronic kidney disease progression as a complication of type 2 diabetes mellitus to prevent end stage renal failure. This was achieved through studding which markers can be used for early detection of diabetic nephropathy.
The aim of the study is to assess the usefulness of serum YKL-40 as an early diagnostic marker of diabetic nephropathy in type 2 diabetes mellitus with and without albuminuria and to evaluate the association of serum YKL-40 with albuminuria in type 2 diabetes with early nephropathy.
To achieve this goal this study included 70 patients with type 2 DM compared with 19 healthy controls.
Patients were further classified according to their Albumin/creatinine ratio into three groups:
group II; Diabetic normoalbuminuric
group III; Diabetic microalbuminuric
group IV; Diabetic macroalbuminuric
The following patients were excluded from the study:-
1- Patients with active urinary tract infection.
2- Patients with Abnormal urinary sediment.
3- Patients with history of other renal disease except diabetic nephropathy.
4- Patients with active or chronic infection.
5- Patients with cancer.
6- Patients with any active or chronic inflammatory conditions.
7- Patients with severe Liver dysfunction .
8- Uncontrolled thyroid disorders.
9- Pregnant females.
Both patients and control groups were subjected to full history taking, Clinical examination, abdominal ultrasonography, Routine Investigation including complete blood count, serum creatinine level, fasting blood glucose, 2-h postprandial blood glucose,glycated hemoglobin (HbA1c%), Serum albumin, ALT, AST, serum total cholesterol and serum triglycerides and special investigations including urinary albumin creatinine ratio,calculation of e-GFR using CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration formula) and serum YKL 40.