الفهرس 
SERUM CERULOPLASMIN LEVEL AND ITS RELATION TO CARDIOVASCULAR DISEASE IN DIABETIC NEPHROPATHY
Ceruloplasmin and cardiovascular disease in diabetic nephropathyOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus consider one of the most frequent chronic diseases worldwide, being among the top five main causes of death in developed countries. It is also becoming epidemic in developing countries with type 2 diabetes mellitus is the most prevalent form of the disease, representing 90% to 95% of cases.
Despite ceruloplasmin (CP) has antioxidant properties being has ferroxidase activity in that it oxidize the more toxic ferrous ions to the less toxic ferric form, elevated circulating CP is associated with cardiovascular disease (CVD). This is possible due to the capacity of CP to promote vasculopathic effects that include lipid oxidation, negation of nitric oxide bioactivity and endothelial cell apoptosis
This study was case control study, included thirty patients with type 2DM recruited from the nephrology department of new EL Kasr El-Aini hospital in period between April to November 2014 & twelve normal volunteers as a control group. Subjects divided into three groups, group (A) includes fifteen patients with diabetic nephropathy but without ischemic heart disease, group (B) includes fifteen patients with diabetic nephropathy and ischemic heart disease and group (C) as control group.
Diabetic nephropathy group were selected by gross albuminuria CKD grade 3-4.
We observed highly significant difference between the three studied groups as regards serum ceruloplasmin being higher in both diabetic groups (A&B) when compared with control group (C) and ceruloplasmin levels higher in group (B) when compared with group (A).
There was positive correlation between serum ceruloplasmin and BMI in both groups A&B but no correlation was found between serum ceruloplasmin level and BMI in group C.
There was statistical significant difference in serum ceruloplasmin level in both groups A&B with presence or absence of diabetic retinopathy being higher in those having retinopathy than those without.
When we did multiple ROC we found when ceruloplasmin level at 328 mg/L the best cut off point for A/C ratio at1234.6 ug/mg creatinine at which specificity was 96.3 and sensitivity was 100%.
In our study we do multiple regression analysis using cardiovascular disease as the dependent variable a number of risk factors associated with cardiovascular disease could be identified. It was found that systolic blood pressure and left ventricle ejection fraction were highly significant independent risk factors for cardiovascular disease in diabetic nephropathy patients.
In conclusion, our study finds that serum ceruloplasmin level was elevated in diabetic nephropathy subjects and its levels higher in those have diabetic nephropathy with ischemic heart disease than those without.