الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is characterized by organ dysfunction arising from the effects of chronic hyperglycemia. The chronic complications of diabetes are classified as macro and microvascular depending on the underlying pathophysiology. The microvascular triad of retinopathy, nephropathy and neuropathy is unique to diabetes. chronic inflammation plays an essential role in the progression of diabetic microvascular complications. Recently, new markers have been studied in the pathogenesis of diabetes and its complications such as Von Willebrand factor. Von Willebrand factor also seems to be a reason for diabetic microangiopathy and its severity. The aim of this study was to study the relation between serum vWF level and diabetic retinopathy in subjects with type 2 diabetes mellitus.
This case control study was conducted on 60 adult subjects (>18 years) divided into three groups: group A included 20 patients with type 2 diabetes with no diabetic retinopathy, group B included 20 patients with type 2 diabetes with non-proliferative diabetic retinopathy and group C included 20 subjects with proliferative diabetic retinopathy. The study subjects were recruited from the outpatient clinic of the Diabetes and Metabolism unit at Alexandria Main University hospital and the Retina outpatient unit of the Ophthalmology department. Patients with type 1 DM, malignancy, acute trauma, recent inflammatory disease and patients with degenerative disease of nervous system were excluded from the study. Moreover, pregnant females were also excluded.
All study participants were subjected to a full medical history assessment and complete physical examination. Microvascular complications of diabetes were assessed. To detect diabetic retinopathy, Fundus examination was performed. The Urinary Albumin-to-Creatinine Ratio (uACR) was calculated and serum Von Willebrand factor level was assessed using ELISA technique. HbA1C, fasting blood sugars, complete blood count, Urinalysis, Liver Function test, Lipid profile and all results were recorded.
The mean serum vWF level was significantly higher in T2DM subjects with diabetic retinopathy (213.73 ± 16.99) than the study group with no diabetic retinopathy (119.05 ± 15.35 (p =0.001). However, no significant difference was found in the mean serum vWF between the two study groups with diabetic retinopathy (p 0.176). Multivariate regression analysis for serum vWF showed that vWF was not independently associated with diabetic retinopathy in type 2 diabetes.