الفهرس 
Complicationsof Diabetes Mellitus
Role of chronic HyperglycemiaOnly 14 pages are availabe for public view
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Abstract
Diabetes Mellitus (DM) is now a recognized pandemic
and treatment costs of DM and its complications are a major
burden on healthcare systems throughout the world. Diabetic
vasculopathy (DV) is one of the most important consequence
of chronic hyperglycemia, in patients with DM.
Peripheral arterial disease (PAD) is a major risk factor
for lower-extremity amputation, especially in patients with
diabetes
Pathogenesis of DV seems to precipitate from a
complex interaction between the blood milieu and the
vasculature, and mediated by several biochemical modulators.
Osteoprotegerin (OPG) is a secretory basic glycoprotein
member of the tumor necrosis factor receptor super family
and acts as an inhibitor of bone resorption, it plays a critical
role in the pathogenesis of atherosclerosis.
Hence in our study we aimed to detect relation of
osteoprotegerin levels to peripheral arterial disease in type 2
diabetic patients.
The study was conducted on 90 diabetic patients who
were classified into a group of 40 diabetic patients with
peripheral arterial disease compared to age and sex matched
randomly selected diabetic patients without peripheral arterial
disease or other macro-vascular complication. All patients of this study were submitted to detailed
history [including smoking history, history of cerebrovascular and cardiovascular disease], clinical examination
including foot examination for peripheral arterial disease
using ABI [ankle brachial index] was done, Cardiovascular
risk assessment using ASCVD Risk Estimator was estimated,
FBS, PPBS, HbA1c%, eGFR using CKD-EPI creatinine 2009
equation, lipid profile, fundus examination and serum OPG
was estimated using ELISA technique.
Our results denoting
Significant higher diastolic blood pressure in diabetic
patients with PAD (p= 0.008)
Significantly lower eGFR in diabetic patient without PAD
(p= 0.023)
Significantly higher serum OPG in diabetic patients with
PAD (p < 0.001)
Upon conducting correlation study only ASCVD showed
significantly positively correlated with OPG in patient
with PAD (p< 0.001)
Upon conducting logistic regression analysis to detect
predictors for PAD LDL, OPG, smoking, ASCVD and
systolic blood pressure were independent factors that
increase the likelihood of being a case