الفهرس 
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Abstract
SUMMARY
iabetes Mellitus (DM) is a group of metabolic diseases
characterized by hyperglycemia, resulting from defects in
insulin secretion, insulin action or both.This may be
microvascular disease, such as nephropathy, retinopathy or
polyneuropathy, and also macrovascular disease as
atherosclerosis. Carotid artery stiffness and intima-media
thickness measured by ultrasonography are correlated with
atherosclerosis and cardiovascular disease in patients with type
1 diabetes.
Orosomucoid is an acute-phase protein produced by the
liver in response to inflammation and infection; however, it has
an anti-inflammatory and immunomodulatory effect. It has
been found to be highly up-regulated in urine samples of
patients with DN.
Our study aimed to determine the level of plasma
orosomucoid in children and adolescents with type 1 diabetes
as an early marker for macro-vascular complications as
atherosclerosis and assess its relation to clinicolaboratory
characteristics of the patients. Plasma orosomucoid levels were
determined by immunosorbent assay (ELISA).
This cross sectional study was carried out on 60 children
and adolescents with type 1 DM, attending the Pediatric
Diabetes Clinic, Ain Shams University, from June 2013 till
D
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February 2014. Their mean age was 12.8 ± 3.9 years, with
mean disease duration 7.5 ± 2.6. Another group of 60 age- and
sex-matched healthy individuals was enrolled as controls with a
mean age was 12.3 ± 3.3 years.
All included patients were subjected to detailed medical
history (age of onset of diabetes, diabetes duration, insulin therapy,
acute metabolic complications, symptomatic hypoglycemic attacks
or episodes of diabetic ketoacidosis and chronic microvascular
complications: retinopathy and neuropathy, thorough clinical
examination and routine work up including; FBG, routine liver
and Kidney function tests, fasting lipid profile, mean HbA1c%,
and CRP. The studied diabetic patients were subdivided into 2
groups: normoalbuminuric and microalbuminuric.
The median plasma orosomucoid levels were
significantly increased in patients with micro-vascular
complications (2200 ± 970μg/ml) and non-complicated patients
(1480 ± 750μg/ ml) compared to healthy controls (p<0.001).
Furthermore, comparison of plasma orosomucoid levels
between type 1 diabetic patients with different stages of
albuminuria revealed that patients with microalbuminuria had
increased levels than normoalbuminuric patients (3800μg/ ml).
Significant correlation was found between plasma
orosomucoid levels and age at diagnosis, diabetes duration,
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HbA1c, triglycerides, total cholesterol, and hs- CRP.Also,
plasma orosomucoid showed positive correlation with CIMT.
Multiregression linear analysis showed that HbA1c,
triglycerides, hs- CRP and CIMT were independently related to
plasma orosomucoid levels in type 1 diabetics.
ROC curve analysis revealed that the cutoff value of
plasma orosomucoid at 1100 μg/mL could differentiate
complicated from non-complicated cases with a sensitivity of
78.3% and specificity of 100%.