الفهرس 
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Abstract
T
ype 1 diabetes mellitus (T1DM) is a common, chronic and metabolic disease characterized by hyperglycemia as a cardinal metabolic feature. Long-term damage, dysfunction and failure of various organs especially eyes, kidneys, nerves, heart and blood vessels are caused by chronic hyperglycemia of diabetes. The incidence of T1DM is reported to be increasing by 3-5% per year, and the number of people with diabetes is estimated to reach 380 million by 2025. Several studies have shown that TIDM is associated with metabolic abnormalities, and alteration of adipose tissue hormones (adipocytokines or adipokines).
Apelin, a recently described adipocytokine, is abundantly expressed in adipose tissue and produced in many body parts by the endothelial cells. Apelin is a bioactive peptide, produced by white adipose tissue. It is synthesized as a prepropeptide then modified into smaller peptides with higher potency. It produces its effects through a cell surface G protein-coupled receptor called APJ.Its extensive tissue distribution suggests that the apelinergic system is involved in a wide range of physiological functions.Apelin plays a beneficial role in energy metabolism,Apelin action on glucose metabolism is additive to insulin as it increases glucose uptake and transport in tissues. Increased concentrations of apelin in type 1 diabetes could be an attempt to compensate for the lack of insulin acting as an anti-diabetic agent.
The aim of this study is to evaluate serum Apelin levels in patients with type 1 diabetes and to correlate the relation between serum Apelin level and glycemic control.
This case control study was conducted on 60 patients recruited from at Ain shams university hospitals, recruited from Ain Shams University Endocrinology and Diabetes outpatient clinics in Cairo during the period from June 2019 to January 2020, and 40 healthy control subjects after informed consents were taken.
In our study, we showed that apelin concentrations were increased in type 1 diabetic patients compared to healthy controls. The potential association of apelin with insulin secretion and action may reveal new pathways in the study of type 1 diabetes. The higher levels of apelin found in our patients with T1DM could be an attempt to compensate for the lack of insulin in the same way that raised apelin levels in obesity or type 2 diabetes could possibly try to overcome insulin resistance and substitute the relative “lack” of insulin. Also, increased levels of serum apelin in T1DM patients may be considered as predicting factor for the ongoing development of vascular sequels, so measuring serum apelin in these patients is of benefit for early detection of disease complications. We also suggested that obesity is a determinant factor in plasma levels of apelin, we could suggest that the increased levels of apelin observed in obesity could be a mechanism to counterpace insulin resistance. Negative correlation was found between Apelin with HbA1c as a marker for glycemic control so apelin may have a promising role as biomarkers in T1DM.