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العنوان
Relation Between Plasma Apelin
level and Peripheral Neuropathy
In a Sample of TYPE-2 Diabetic
Egyptian Patients /
المؤلف
Helal, Zainb Yousry El-Azab.
هيئة الاعداد
باحث / Zainb Yousry El-Azab Helal
مشرف / Salwa Seddik Hosny
مشرف / Merhan Samy Nasr
مناقش / Rana Hashem Ibrahim
الموضوع
Internal Medicine.
تاريخ النشر
2017.
عدد الصفحات
160p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الطب الباطني
تاريخ الإجازة
1/1/2017
مكان الإجازة
جامعة عين شمس - كلية الطب - الباطنة العامة
الفهرس
Only 14 pages are availabe for public view

from 160

from 160

Abstract

SUMMARY
ype two diabetes mellitus is a metabolic disorder
characterized by chronic hyperglycemia with disturbance
of carbohydrate, fat and protein metabolism which take place as
a result of either insulin resistance and/or insulin deficiency. It
accounts for 90–95% of all diabetes. This medical condition
required a chronic monitoring and treatment throughout patient
life; the treatment will involve several aspects like self-care
measures, lifestyle changes and in some cases medications.
High blood sugar when remain for long time will mainly cause
macrovascular and microvascular complications.
DSPN is a symmetrical, length dependent sensorimotor
polyneuropathy attributable to metabolic and microvessel
alterations as a result of chronic hyperglycemia exposure
(diabetes). It affects Sensory nerves, which enable people to
feel pain, temperature, and other sensations and Motor nerves,
which control the muscles and give them their strength and
tone. It is the most common form of the diabetic neuropathies.
All patients with type 2 diabetes should be assessed annually
for DSPN using the medical history and simple clinical tests.
Apelin is a peptide produced and secreted by white adipose
tissue, discovered in 1998 by tatemoto and other co-workers. It is
synthesized as preproapelin, a protein containing 77 aminoacids
which is then cleaved to shorter active fragments. As an
adipokine, apelin plays a role in the regulation of many biological
T
Summary 
120
functions, including body energy homeostasis and glucose
metabolism, water balance, and immunity.
Apelin levels were found to be higher in diabetic patients
than healthy controls. When diabetic patients were evaluated,
apelin levels of DPN group were found to be significantly
higher than DM patients without DPN. It is supposed that
elevated apelin levels may indicate the metabolic state causing
diabetic complications. Apelin might reflect endothelial
dysfunction, microangiopathic changes and inflammation
mechanisms in diabetic patients which all play some role in
DSPN pathogenesis. apelin might be used as markers of DSPN.
This study was conducted on 80 subjects,60 with type 2
DM, Their age ranged from 40 to70 years old and BMI ranged
from 28 to38 Kg/m2 from the outpatient clinic of Dar El-Shefa
hospital and 20 healthy subjects with age, sex & BMI matched
taking as control from November 2016 to march 2017. Subjects
were be divided in to three groups diabetic patients with
neuropathy, diabetic patients without neuropathy and non
diabetic control.
All patients were subjected to full history taking, full
clinical examination, Hb A1C, fasting plasma glucose, lipid
profile [total cholesterol, HDL, LDL, TG], nerve conduction
study, plasma apelin level and fasting insulin [to calculate
HOMA-IR]. All patients with neuropathy due to other causes
other than diabetes, renal or hepatic disease, coronary heart
disease, retinopathy, any end organ failure, thyroid disease, any
Summary 
121
current infection and hypertensive patient on ARBS or ACEI
treatment were excluded from the study.
Our results show that apelin levels were increased in
diabetic patients when compared with healthy control subjects.
Further, when the apelin levels were evaluated with regard to the
presence of neuropathy, diabetic patients with neuropathy had
significantly higher apelin levels than the control subjects. So
apelin level seems to be beneficial biomarker in early detection of
type-2 diabetes, insulin resistance, glucose intolerance and
diabetic complications (neuropathy, nephropathy and
retinopathy). Also it seems to have a beneficial role in follow up
and treatment of diabetic neuropathy regarding to its anti
inflammatory, anti oxidant and anti insulin resistance effects