الفهرس 
Overview of Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Globally, an estimated 422 million adults are living
with DM according to WHO in 2016. This number is
expected to double by 2030.
In DM, protein, lipid and nucleic acid alteration is
involved, as well as cross-linking and formation of nondegradable
aggregates, such as AGEs. Formation of
endogenous or uptake of dietary AGEs can lead to further
protein modifications and initiation of several inflammatory
signaling pathways.
AGEs are proved to affect nearly every type of cell
and molecule in the body, and are thought to be a
significant factor in aging and some age-related chronic
diseases. Their accumulation has been implicated in
Alzheimer’s disease, cardiovascular diseases, and strokes.
In the context of cardiovascular disease, AGEs can
induce cross linking of collagen, leading to vascular
stiffening and entrapment, as well as glycation and
oxidation of LDL in the artery walls. Oxidized LDL is the
major factor in the development of atherosclerosis. They
also induce systolic and diastolic dysfunction by direct
action on myocardium.
Evidence also suggests that AGEs contribute to
cognitive impairment by increasing the formation and
deposition of neurofibrillary tangles and amyloid plaques which may exacerbate existing neurodegenerative
processes, such as Alzheimer disease. Therefore, DM may
impact tremendously on societies in the upcoming decades
as world population ages.
In Egypt studies addressing effect of AGEs on
coronary risk and cognitive and executive functions in
elderly are scarce.
The aim of the current thesis was to study the
relationship between AGEs and Coronary risk factors and
Cognitive and Executive Function in Elderly Diabetics.
A comparative cross sectional study was conducted
on 90 elderly subjects, 60 years or older. Subjects were
recruited from Ain Shams University Hospitals, in patient
departments and outpatient clinics.
The subjects were divided into three groups. group I:
(30) healthy subjects without DM and without comorbidities,
group II: (30) subjects with DM and without
co-morbidities and group III: (30) subjects with DM and
with co-morbidities.
All participants were subjected to history taking and
examination with special emphasis on duration of DM,
mode of treatment and complications as well as
cardiovascular co-morbidities. FBS, 2 hrs PP, HbA1C, lipid
profile and AGEs were measured in all subjects. Coronary
risk was calculated for all subjects through online AHA calculator. Finally, cognitive and executive function was
tested in all subjects by MMSE, forward and backward
digit span, verbal fluency (animal category), judgment and
abstraction.
The study concluded that MMSE was higher in
group I (healthy subjects) than diabetic groups with
statistical significance. Coronary risk was higher in diabetic
groups than group I subjects. AGEs were lower in group III
than other groups. A positive correlation was detected
between serum glucose and AGEs in group I and II.
Moreover, a significant positive correlation was detected
between AGEs and coronary risk in study group II.
AGEs and coronary risk were not significantly
associated with worse cognitive or executive function.
Forward span was negatively correlated with FBS
and 2hrs PP in group I and III respectively and MMSE was
negatively correlated with 2hrs PP in group II.