Levels of serum intercellular and vascular adhesion molecules in insulin dependent diabetic nephropathy patients

The study evaluated the possible significant role of soluble intercellular and vascular adhesion molecule- 1 [sICAM-1 and sVCAM-1], sE-selectin and interluekin-l beta in development nephropathy in patients with insulin dependent diabetes mellitus [IDDM]. This study included 60 patients with type 1 diabetes mellitus [IDDM], together with 20 healthy control subjects. Patients were divided into 3 groups according to the onset of disease. All studied groups were subjected to clinical and laboratory evaluation of serum soluble sIC AM- 1, sVCAM-1, sE-selectin, IL-l beta in association with microalbumin, and CRP. A highly significant elevation of soluble adhesion molecules [sICAM-1, sVCAM -1 and sE-selectin] and microalbuminuria were observed in patients with IDDM, while there was no significance difference in ILl-beta in the same patients. Our findings may have clinical implications, since they may indicate that, these adhesion molecules are known as very strong marker for renal complications and the circulating forms of these adhesion molecules have been associated with clinical vascular events and all-cause mortality in the renal population

Sulfur-containing amino acids, C-reactive protein, vitamin B[12], folate and mortality in haemodialysis patients

Cardiovascular disease [CVD] is common in haemodialysis [HD] patients with chronic renal insufficiency and is the leading cause of death. The accelerated state of atherosclerosis found in these patients is due to a combination of different mechanisms. Recent studies confirm that inflammation plays an important role in the development of atherosclerosis. Plasma SAA, CRP, B[12] and folate in three different groups of patients with chronic renal failure [CRF] [one group without dialysis under conservative treatment, one pre-haemodialysis and one post-haemodialysis] were investigated and compared to control group. Our study aimed to analyze, whether there is a relationship between the plasma concentrations of SAA, CRP as a predictor of mortality in HD patients as well as systemic vitamin concentration, measured as levels of vitamin B[12] and folate. The present study shows that many abnormalities are observed in plasma SAA concentrations in all patient groups accompanied with increased level of CRP. The patients with uremia have evidence of slight deficiency in folate and vitamin B12 levels. Based on theoretical and practical background of other studies, supplementation with both folate and vitamin B[12] is recommended to normalize the detected abnormalities in SAA concentrations especially Hcys and hence has a beneficial effect on the cardiovascular risk in CRF and dialysis patients. These results suggest that SAA and inflammation are the main risk factor for mortality in haemodialysis patients. Further studies are required to demonstrate that this effect is associated with an improved in morbidity and mortality. As the study was carried out in a relatively limited number of patients, the results need to be confirmed in a larger patient population

Evaluation of adiponectin as a risk factor in cardiovascular diseases

Cardiovascular disease [CVD] represents one of the worldwide major problems with increasing deaths every year. Diseases like diabetes, hypertension, chronic renal failure and other environmental and genetic factors can compromise the CVD patients. Clinically, the screening and monitoring of CVD requires several biochemical parameters as well as medical ones. Therefore, the purpose of this study is to assay the usefulness of adiponectin as a risk factor in CVD. Adiponectin is synthesized and secreted by the adipose tissue and it was supposed to have anti-inflammatory and anti-hyperlipidemic activity making it a promising risk factor in CVD patients. Here, we examined the associations between plasma levels of adiponectin and body mass index, fasting blood sugar, total cholesterol, HDL-C, LDL-C, triglycerides and hypertension. Forty-three individuals from Ain Shams Specialized Hospital were classified into three groups according to their medical coronary implications, AMI, UAP and SAP, in addition to 15 healthy subjects as a control group. The results indicate a high significant decrease [p < 0.001] in the plasma levels of adiponectin in AMI and UAP compared to the control group. In addition, we found that at AMI, UAP and SAP patients there is a high significant negative correlation between adiponectin and BMI, FBS, total cholesterol, triglycerides and the major cardiac risk factor cTn-T. Also high significant positive correlation with HDL-cholesterol was observed. Therefore, we assume that adiponectin can be a promising risk factor other than the well-known traditional risk factors for cardiovascular disease patients and it can represent a good way to screen CVD through monitoring and assaying its plasma level