الفهرس 
Definition of diabetes mellitusOnly 14 pages are availabe for public view
 |  | from | 206 |  |  |
| | | from | 206 | | |
Abstract
Diabetes mellitus prevalence and its complications have a major global health threat where 90-95% of all diabetes is type 2 diabetes.
Diabetic patients are characterized by chronic hyperglycemia and the development of diabetes specific microvascular pathology in the retina, renal glomerulus, and peripheral nerve.
Diabetes is also associated with accelerated atherosclerotic macrovascular disease affecting arteries that supply the heart, brain, and lower extremities. So, diabetic complications are considered to be the main reason for morbidity and mortality in patients with diabetes mellitus.
Interleukin-17 (IL-17) is a potent proinflammatory cytokine participation in autoimmune and inflammatory diseases.
IL-17 may play a role in the development of endothelial damage and vascular dysfunction, leading to systemic inflammation and endothelial dysfunction which may be involved in the pathogenesis of diabetes mellitus and its complications.
On the other hand, insulin like growth factor-1 (IGF-1) is implicated in the complications of diabetes and plays a vital role in the growth and cellular proliferation in humans.
The collection of samples started in June 2018 and ended in December 2018. The study included 90 clinically diagnosed type 2 diabetic patients who were recruited from the outpatient clinic of the National Institute for Diabetes and Endocrinology ”NIDE”, El -Kasr El-Einy Street, Cairo, Egypt. Besides, 30 healthy comparable control subjects (without diabetes).
All subjects gave an informed written consent for participation and the study was approved by the ethics committee of the General Organization for Teaching Hospitals and Institutes.
Subjects were classified in to 2 main groups:
Control group : includes 30 (12 males and 18 females) healthy subjects matched for age, sex and socioeconomic classes with negative C-reactive protein, normal Blood Glucose, and normal kidney function test.
T2DM Groups : a population of 90 Diabetic mellitus type 2 patients, this group will be divided into four subgroups according to diabetic complications:
1. Without complication group: includes 17 (10 males and 7 females) T2DM patients (without).
2. Cardiovascular complications group: includes 22 (8 males and 14 females) T2DM patients (cardio).
3. Retinopathy complications group: includes 27 (10 males and 17 females) T2DM patients (retino).
4. Both retinopathy and cardiovascular complications group: includes 24 (9 males and 15 females) T2DM patients (both).
- In target patients: The presence of macrovascular complications (CVD) is defined as the clinical presentation with evidence for CHD, congestive heart failure, and/or electrocardiograph evidence of myocardial infarction or coronary angiography.
The presence of microvascular complications was evaluated by assessment of retinopathy which was diagnosed on the basis of history and fundus examination for the presence of micro aneurysms, dot and blot hemorrhages or retinal changes such as edema and thickening.
All patients and controls were subjected to:
a- Full history taking; including age, gender, diabetic duration, family history of DM and Current daily oral antidiabetic regimen or any current medications.
b- Body mass index (BMI) calculation; calculated as weight ’Kg’ / (height ’m’)2.
c- Clinical examination (to exclude other diseases). d- Laboratory investigations:
Fresh morning urine samples were collected from patients to estimate albuminuria.
10 ml venous blood sample was withdrawn from each subject after an overnight fasting (8-12 hours). The venous blood sample was divided into two tubes.
- 2ml added to EDTA tube (whole blood to estimate HbA1c immediately after samples collection).
- The remainder 8 ml was allowed to clot at room temperature then centrifugated. Serum was separated and divided into two aliquots; one of them was stored at temperature -20 оC till the time of assay of IL-17 and IGF-1. IL-17 and IGF-1 was estimated by using ELIZA technique.
The other was used to estimate the following parameters:
Serum fasting blood glucose level which was estimated immediately after centrifugation.
Liver enzymes; including AST and ALT.
Kidney function tests; including blood urea and serum creatinine.
Lipid profile; including total cholesterol (T-C), triacylglycerol (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), and Lipoprotein-a.
Highly sensitive-CRP.
Inclusion and exclusion Criteria for subjects’ selection:
a- Diabetic patients had to be:
40 to70 years of age at the beginning of study.
Clinically diagnosed as type 2 diabetic patients.
Duration of diabetes patients with complications is from 5 to 10 years except the group which has no complications ≤ 5 years.
b- Control subjects had to be:
With comparable age, sex, BMI range and pubertal stage to the diabetic group.
Without any acute disease or clinical conditions involving the endocrine–metabolic system.
Neither smokers nor alcoholics.
Not receiving any medications affecting the endocrine-metabolic system (e.g. anti-thyroids, glucocorticosteroids .etc).
Neither hypertensive, hyperlipidemic nor obese.