الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
The present study aims to elucidate the role of heparanase urinary level and gene expression in type 2 diabetic patients with and without nephropathy and to evaluate their relation with various clinical and biochemical parameters . This study wascarried out on 45 type 2 diabetic patients divided into 3 subgroups according to their urinary albumin creatinine raio into 15 patients with normolbuminuria, 15 patients with microalbuminuria and 15 patients with macroalbuminuria.They were compared to 10 normal subjects as a control group. All cases were subjected to the following: 1-Full history taking 2-Complete clinical examination. 3-Abdominal ultrasonography 4- Routine laboratory investigations: - Fasting and postprandial blood glucose levels. - Glycosylated hemoglobin percentage. - Complete urine analysis. - Kidney function tests (serum creatinine , blood urea and eGFR ) - Urinary albumin creatinine ratio. 5- Specific laboratory investigations: -Urinary heparanase level -Heparanase mRNA gene expression in leukocytes The results of the present study showed the following: • Albumin creatinine ratio (ACR) was significantly elevated in diabetics with overt nephropathy (macroalbuminuria) as compared to controls, those with normoalbuminuria and microalbuminuria. • Estimated glomerular filteration rate (eGFR) was significantly decreased in diabetic groups with nephropathy as compared to control. • Urinary heparanase level was significantly increased in diabetics with nephropathy as compared to control group and those without nephropathy.Heparanase level was positively correlated with albumin creatinine ratio but negatively correlated with estimated glomerular filtration rate. • Heparanase mRNA gene expression was elevated in diabetics with nephropathy as compared to control group and those without nephropathy. Also, heparanase mRNA gene expression was positively correlated with urinary heparanase level. • Using ROC curve analysis, the sensitivity and specificity of heparanase level in patients with diabetic nephropathy was 96% and 93% respectively, the sensitivity and specificity of heparanase mRNA gene expression was 91% and 87% respectively. • Multivariate logistic regression analysis showed that heparanase level is an independent predictor for diabetic nephropathy in type 2 diabetic patients. Conclusions from this work, it could be concluded that: • Urinary heparanase level can be considered as a diagnostic biomarker for diabetic nephropathy in type 2 diabetic patients. • Heparanase gene expression may have an important role in the pathogenesis of diabetic nephropathy and may be regarded as a useful target for elucidating the molecular mechanisms associated with diabetic nephropathy .Clearly, further well –designed prospectivestudies are required to prove this hypothesis.