الفهرس 
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Abstract
Diabetes mellitus (DM) is a heterogeneous metabolic disorder characterized by the presence of hyperglycemia due to impairment of insulin secretion, defective insulin action or both. It is an important cause of morbidity and mortality worldwide. Type 2 diabetes mellitus (T2DM) accounts for more than 90% of patients with diabetes and is associated with microvascular and macrovascular complications. Diabetic nephropathy (DN) is one of the most serious long-term microvascular complications of DM and is known to be the leading cause of chronic kidney diseases and end-stage renal disease worldwide. The risk of developing diabetic nephropathy starts with albuminuria, progressing from microalbuminuria to macroalbuminuria. Diabetic Retinopathy (DR) is an ophthalmic disease that damages retinal blood vessels and causes impaired vision and may even lead to blindness if it is not diagnosed in early stages. Diabetic peripheral neuropathy (DPN) is the most common diabetic complication characterized by damage to nerve glial cells, their axons and endothelial cells with a prevalence ranging from 30% up to 50% of T2D patients. Human milk fat globule epidermal growth factor 8 (MFG ‐E8), also known as lactadherin, is a secreted glycoprotein that plays essential roles in the clearance of apoptotic cells and angiogenesis. MFG‐E8 is secreted by various cells, including macrophages, dendritic cells, endothelial cells and pericytes. In addition to the enhancing role in phagocytosis, MFG-E8 binds to its target cells expressing MFG-E8 receptors and acts as a ligand, which modulates inflammatory responses. The aim of the present study was to investigate the role of serum MFG-E8 in early diagnosis of microvascular complications in type 2 diabetic patients. The studied groups were classified as follow: group A: 20 patients with T2DM, free from any vascular complications (no microvascular complications and no subclinical atherosclerosis with carotid intima media thickness < 0.9 mm). group B: 20 patients with T2DM with subclinical atherosclerosis (CIMT ≥ 0.9 mm) and free from any early microvascular complications. group C: 20 patients with T2DM with early microvascular complications and no subclinical atherosclerosis (CIMT < 0.9 mm). group D: 20 patients with T2DM with both subclinical atherosclerosis (CIMT ≥ 0.9 mm) and early microvascular complications. All patients of the study were subjected to: 1- Complete medical history. 2- Clinical examination including neurological and ophthalmological examination. 3- Investigational studies: a- Radiological investigations: - CIMT was measured for all patients to define macrovascular injury and subclinical atherosclerosis. b- Laboratory investigations: - Fasting plasma glucose. - Postprandial plasma glucose. - Hb A1c level. - Urinary albumin excretion rate. - Serum hs-CRP. - Lipid profile including: serum Triglycerides, HDL cholesterol, LDL cholesterol and total cholesterol. - Serum (MFG-E8) measured by ELISA technique. The following results were obtained: The present study showed that there was a significant decrease in the mean value of serum MFG-E8 concentrations in groups C (T2DM with early microvascular complications) and D (T2DM with both early microvascular complications and subclinical atherosclerosis) when compared to those in groups A (T2DM without any vascular complications) and B (T2DM with subclinical atherosclerosis only). Also serum MFG-E8 concentrations were markedly lower in group D patients than those in group C and there was no significant difference in serum MFG-E8 concentrations between group A and B. Serum MFG-E8 negatively correlated with age, FPG, PPG, HbA1C, UAER, hs-CRP and positively correlated with HDL-C while didn’t correlate with BMI, TG, TC, LDL-C or CIMT.