الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
 |  | from | 181 |  |  |
| | | from | 181 | | |
Abstract
SUMMARY AND CONCLUSION
Type 2 diabetes mellitus is the most common human endocrine disease in which diabetic nephropathy take place nearby 25% approximately of patients.
Type 2 diabetes mellitus and type 2 diabetic nephropathy considered to be an inflammatory process in which immune cells are involved in its development and progression apart from traditional metabolic and hemodynamic risk factors.
Our study included 3 groups; group A: 30 type 2 diabetic nephropathy patients (on basis of proteinuria and reduced GFR), group B: 30 type 2 diabetic patients (according to American Diabetes Association, 2013 criteria) and group C: 20 healthy controls of the same age and sex.
Our study, aimed to determine the balance between T helper 17 and regulatory T cells in type 2 diabetic patients having diabetic nephropathy in relation to type 2 diabetic patients without renal involvement and healthy individuals.
The results revealed that there was higher mean Th17 and Th17/Treg cells ratio among type 2 diabetic nephropathy patients compared to other groups. And, there was lower mean Treg cells among type 2 diabetic nephropathy patients compared to other groups with very high statistically significant differences.
Also, there was higher mean Th17 and Th17/Treg cells ratio among type 2 diabetic patients compared to healthy individuals with very high statistically significant differences. While, type 2 diabetic patients and healthy individuals were comparable as regards mean Treg cells with no statistical significant difference.
Within our knowledge, this is the first study to be conducted in the world to show the relation between Th17, Treg and Th17/Treg cells ratio from one side and BUN, serum creatinine and creatinine clearance one the other side in type 2 diabetic patients. Also, our study considered the relation between the grade of nephropathy affection by ultrasound and Th17, T reg and Th17/T reg cells ratio.
Our study showed that there was a strong positive correlation between BUN, serum creatinine, proteinuria and the grade of nephropathic affection by the ultrasound from one side and Th 17 and Th 17/T reg cells ratio on the other side. But this correlation was strongly negative with T reg cells.
Inversely, there was a strong positive correlation between the creatinine clearance from one side and T reg cells on the other. This correlation became strongly negative with Th17 and Th 17/T reg cells ratio.
Also, our study revealed that measuring Th 17 and T reg cells levels in type 2 diabetic patients can be used as an excellent screening test to detect renal involvement in those patients; so increased Th 17 cells level or suppressed T reg cells level in patients with type 2 diabetic patients indicates renal involvement even before occurrence of proteinuria or reduced GFR with a sensitivity and specificity of 100%.
from our study we can conclude the importance of regulatory T cells in the protection from nephropathy in type 2 diabetic patients. While, T helper 17 cells are associated with diabetic nephropathy.