الفهرس 
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Abstract
There was insignificant difference between the three groups regarding sex distribution, But age was higher in diabetic with nephropathy patients compared to control group (P value <0.001).
• BMI were comparable among the studied groups.
• SBP and DBP were comparable among the studied groups.
• Duration of DM in years and A/C ratio were significantly higher in diabetic with nephropathy patients compared to only diabetic patients (P value <0.001).
• HbA1C, TNFα and RQ were significantly higher in diabetic nephropathy patients compared to only diabetic patients and controls and was significantly higher in only diabetic patients compared to controls (P value <0.001).
• S.Creatinine was significantly higher in diabetic nephropathy patients compared to controls (P value= 0.009) and only diabetic patients (P value=0.006) whereas s.creatinine was insignificantly different between only diabetic patients and controls.
• eGFR was significantly lower in diabetic nephropathy patients and only diabetic patients compared to controls (P value <0.001) and was insignificantly different between diabetic nephropathy patients and only diabetic patients.
• There was a significant positive correlation between RQ and other parameters (Albumin/creatinine ratio, HbA1C, s.creatinine, duration of diabetes and TNF-α),but a significant negative correlation between RQ and eGFR and an insignificant correlation between RQ and BMI was observed.
• A significant positive correlation between TNF- α and other parameters (Albumin/creatinine ratio, HbA1C, s.creatinine, duration of diabetes and RQ), a significant negative correlation between TNF- α and eGFR but insignificant correlation between TNF- α and BMI were found.
Conclusion
Our results indicated that MALAT1 showed significant positive correlation with urine Albumin/creatinine ratio, HbA1C, s.creatinine and duration of diabetes and a significant negative correlation with eGFR. Also, there was positive correlation between MALAT1 and TNF- α in diabetic nephropathy suggesting involvement of MALAT1 in the pathogenesis of DN.
Serum TNF-α was significantly increased in patients with DM and DN patients but was higher in patients with DM-CKD, which designates that TNF-α can participate in progression of DM to DN and might play an important role in mediating DN.
Also, there was apositive correlation between MALAT1 and TNF- α in diabetic nephropathy suggesting epigenetic role of MALAT1 in induction of inflammation in DN.
Limitations
• It was a single-center study, and the results may differ elsewhere.
• A relatively small sample size.
• We could not investigate the association between both lncRNAs levels and various grades of renal dysfunction or the difference of expression between pre- and post-dialysis sessions because of limited sample study.
Recommendations
• Further clinical studies are needed with multicenter cooperation to validate our findings.
• MALAT1 was identified as a novel biomarker to predict DN. This provides a promising biomarker for future strategy to diagnose and treat DN by regulating the expression of lncRNA MALAT1.
• Future studies are needed taking in consideration other potential confounders such as exposure to different environmental factors (such as type of treatment, nutrition, etc.) and additional epigenetic factors.
• Once the targets of both lncRNAs in DN with ESRD have been experimentally and biologically validated, their functional role could provide a comprehensive view of the pathogenesis of this derangement and could lead to the development of novel therapeutic approaches.