ABSTRACT
Background: the incidence of cardiovascular disease is remarkably increased in dialysis patients and accounts for the major cause of death in this group of subjects. The relative risk of mortality from ischemic heart disease has been estimated as 22-fold higher in dialysis patients than in the background population. This high cardiovascular morbidity and mortality in chronic haemodialysed patients has led to the hypothesis of 'accelerated atherosclerosis. Endothelial dysfunction and chronic inflammatory activity, two important phenomena in atherogenesis, can be found in ESRD
Aim of work: the aim of the study to assess serum level of ICAM-1 and Nitric oxide as markers of endothelial dysfunction in hypertensive hemodialysis patients
Patients and Methods: the current study included 75 individuals divided into 3 groups, Group I served as control group, it included 25 apparently healthy normotensive subjects, their age ranged from 20 to 45 years old [mean +/- SD 40 +/- 4.8 years] all of them were males. Group II included 25 patients with hypertension, the duration of hypertension from 1 to 5 years, their age ranged from 35 to 60 years old [mean +/- SD 4 7. 7 +/- 5 .4 years] all of them were males. Group III included 25 patients on regular hemodialysis 3 times/ week. They had been undergoing dialysis for a mean of 6.3 +/- 2.9 years. Their age ranged from 20 to 55 years old [mean +/- SD 41.8 +/- 8.4 years], all of them were males. All groups were subjected to: Complete history taking and through clinical examination including assessment of blood pressure. Laboratory examination including renal function tests including, blood urea nitrogen, serum creatinine, fasting and 2 hours postprandial blood glucose. Complete blood count on the automated coulter counter. Total. LDL, Triglycerides and HDL cholesterol were measured by enzymatic analytical chemistry. Soluble intercellular adhesion molecule-1 [sICAM-1] and Nitric Oxide as markers of endothelial function. sICAM-1 was assayed by ELISA methods and Nitric Oxide assessed by Gresis reaction
Results: in this study when we compared HD patients to healthy nonnotensive subjects and non complicated hypertensive patients, we found significant increase of soluble ICAM-1 level in the circulation of HD group of patients. Also this study had shown that serum levels of sICAM-1 is significantly increased in uncomplicated hypertensive patients than nonnotensive subjects. As regard Nitric oxide there was a significant reduction in No- level in hypertensive patients and HD patients with hypertension when compared with normal individuals and more lower in haemodialysed hypertensive group than non haemodialysed hypertensive group
Conclusion: hypertensive chronic hemodialysis patients are at risk to develop endothelial dysfunction which may explain accelerated atherosclerosis that occurred in chronic hemodialysis patients
ABSTRACT
Background: Patients with diabetes mellitus are assumed to be at increased risk for developing diabetic retinopathy and diabetic nephropathy, probably because of diabetes mellitus associated with endothelial dysfunction. So, factors related to endothelial dysfunction may be considered as non traditional risk factors for diabetic retinopathy
Objectives: This study aimed at evaluation of the Von Willebrand factor [vWF], microalbuminuria and reduced glomerular filtration rate as predictors of developing diabetic retinopathy in patients with type 2 diabetes mellitus
Patients and Methods: The study included 126 subjects divided into two groups. Group I included 30 apparently healthy individuals served as control group, 21 males and 9 females. Group II included 96 patients known to have type 2 diabetes mellitus, 65 males and 31 females. Assessment of type 2 diabetic patients was done by history taking, clinical examination and laboratory investigations, which included: Fasting and 2-hours postprandial blood glucose, complete urine analysis, Glycated hemoglobin [HbA 1C], microalbuminuria by radioimmunoassay, plasma levels of vWF, fundus examination to determine the degree of retinopathy by direct and indirect ophthalmoscope, renal function tests, and glomerular filtration rate [GFR]
Results: In group II, microalbuminuria was found in 89 [92. 7%] patients, high vWF was found in 17 [17. 7%] patients, and low GFR was found in 49 [51%] patients, In group II, diabetic retinopathy was found in 49 [51%] patients, and 47 [49%] patients had no diabetic retinopathy changes. Non proliferative diabetic retinopathy was found in 39 [40%] patients and proliferative diabetic retinopathy was found in 1 O [11 %] patients. In group II, vWF was strongly correlated with presence of retinopathy and low GFR. Retinopathy was strongly correlated with high vWF, microalbuminuria and low GFR. Low GFR was strongly correlated with high vWF, microalbuminuria, and presence of retinopathy
Conclusions: Diabetic patients with long duration of illness, microalbuminuria, low glomerular filtration rate, and high vWF are more susceptible to the development of diabetic retinopathy. Von willibrand factor [vWF] with microalbuminuria and reduced glomerular filtration rate can be used as a predictor of developing diabetic retinopathy in patients with type 2 diabetes mellitus
ABSTRACT
Purpose: The purpose of the present study was to determine the levels of homocysteine, folic acid, and Vitamin B[12] in subjects with noise-induced hearing loss. Furthermore, possible links between these parameters and noise-induced hearing loss were aimed to be evaluated
Study design: In the present study, blood samples were obtained from all subjects after overnight fasting for biochemical analysis. We examined the levels of homocysteine, Vitamin B[12] and folic acid levels in subjects with noise-induced hearing loss. Twenty-eight male patients with noise-induced hearing loss [mean age 37+/-5 year] were included in the study group whereas the control group was composed of 32 healthy male volunteers [mean age 36+/-4 year]
Results: It was found that homocysteine levels of subjects with noise-induced hearing loss was significantly high compared to healthy controls [P<0.05]. On the other hand, Vitamin B[12] and folic acid levels of patients with noise-induced hearing loss were determined to be significantly low compared to the con1rols [P<0.05 and <0.01, respectively]
Conclusion: Our findings indicate that there might be a link between increased homocysteine levels and noise-induced hearing loss. Since increased homocysteinc levels cause elevated levels of free radicals in addition to its atherogenic and thrombogenic effects. Further experimental studies are needed to decipher how this relationship is linked
ABSTRACT
Hyperglycemia has been causally linked to vascular and glomerular dysfunction by a variety of biochemical mechanisms, including a glucose-dependent abnormality in nitric oxide [NO] production and action. Nitric oxide is a candidate for mediating hyper filtration and the increased vascular permeability induced by diabetes. Serum nitric oxide concentrations were assessed in 30 children and young adolescent with type 1 diabetes, 15 with and 15 without microalbuminuria compared with a well-balanced group of healthy control subjects. In all subjects, glomerular filtration rate [GFR] was determined using Cockcroft formula. Our study showed that serum nitric oxide values were significantly higher in microalbuminuria diabetic patients than in the other 2 groups [group I versus group II; 46.7 + 7.9 versus. 32.2 +/- 6.1 [micro]mol/l, P < 0.05; while group I versus group III, 46.7 +/- 7.9 versus 25.4 +/- 4.2 [micro]mol/11 P < 0.02]. GFR was significantly and positively related to albumin excretion rate [AER] levels [r[2] = 0.75, P < 0.0001], whereas Serum nitric oxide was independently associated with both AER and GFR values [B = 2.086, P < 0.05, B = 1.273, P < 0.0085, respectively]. These findings suggest a strong link between circulating nitric oxide, glomerular hyper filtration, and microalbuminuria in type 1 diabetic patients with early nephropathy. Mean HbA[1c] serum concentration was significantly higher in microalbuminuric than in normoalbuminuric diabetic subjects [P < 0.05] and was independently associated with AER values, suggesting a role for chronic hyperglycemia in the genesis of diabetic nephropathy. HbA[1c] serum concentration was significantly and positively related to serum nitric oxide [r[2] = 0.45, P = 0.0063] and GFR values [r[2] = 0.57, P = 0.0011], suggesting that chronic hyperglycemia may act through a mechanism that involves increased nitric oxide generation and/or action
Conclusion: we suggest that in type 1 diabetic patients with early nephropathy, chronic hyperglycemia is associated with an increased nitric oxide biosynthesis and action that contributes to generating glomerubr hyper filtration and persistent microalbuminuria
ABSTRACT
The pathogenesis of atopic dermatitis [AD] is still unknown. A recent study has shown that inducible nitric oxide synthase [i NOS] is expressed in the atopic skin lesion, suggesting the involvement of nitric oxide [NO] in the skin inflammation of AD. Soluble E-selectin [sE-selectin] is also known to be a serological marker in AD which reflects disease activity. Therefore, the aim of this study was to evaluate the role of serum nitrate and sE-selectin concentrations in the pathogenesis, relation to the disease severity and clinical course of infants and children with AD. Serum Nitrate and sE-selectin levels were assessed in 54 patients with AD [28 boys and 26 girls] aged 4-84 months: median 17months, and 16 nonatopic controls [9 boys and 7 girls] aged 6-60 months; median 18 months. Serum nitrate was measured by an enzymatic one step assay with nitrate reductase and serum sE-selectin was measured by radioimmunoassay. Serum nitrate and sE-selectin concentrations in patients with AD were significantly increased as compared to non-atopic controls and there were also significant differences between subgroups of AD [mild, moderate and severe] as compared to controls and among subgroups themselves. The levels of both markers were significantly diminished after treatment of severe cases of AD. Significant correlations were present between serum nitrate levels, sE-selectin levels, disease activity and eosinophilic count, but no correlation was found between serum nitrate and sE-selectin levels. Our results indicate that NO may be involved in the pathogenesis of vasodilatation and erythema in AD skin, also sE-selectin may be a useful parameter in the monitoring of AD. NO and sE-selectin are good and useful markers for assessment of the severity and clinical course of AD in infants and children