Level of chemerin and anti-mullerian hormone in Egyptian obese women with polycystic ovarian syndrome

Background: Chemerin is a newly discovered adipokine that regulates adipocyte development, metabolic function as well as immune function. Anti-Mullerian hormone [AMH] is a dimeric glycoprotein that belongs to the transforming growth factor-beta family

Aim of the study: was to evaluate the serum levels of Chemerin and AMH in one trial to show their possible involvement in the pathogenesis of PCOS and their association with obesity

Subjects and methods: This study was performed on eighty subjects divided into 4 groups: Group I: 20 non-obese control [BMI< 30], Group II: 20 non-obese patient with polycystic ovarian syndrome [BMI< 30], Group III: 20 obese Control [BMI >/= 30] and Group IV: 20 obese patient with PCOS [BMI >/= 30]. Serum levels of Chemerin and AMH were estimated by ELISA

Results: Results showed a significant increase in serum levels of Chemerin and AMH in [non-obese and obese] PCOS groups when compared to their controls. Results showed also a significant increase in the serum level of Chemerin in obese PCOS group when compared to non-obese PCOS group. While a significant decrease in serum level of AMH in obese PCOS group when compared to non-obese PCOS group. There were a significant positive correlation between Chemerin and AMH in PCOS groups

Conclusion: Chemerin together with AMH may be used as a biomarker for early detection of PCO and Clinical parameters as Infertility and Hyper and rogenism in women with PCOS

Assessment of urinary cystatin c in TV pel diabetic children

Background: Diabetes is the disease of this century; its incidence had progressively increased in the last few years especially in young ages. Cystatin C is a single chain non glycosylated basic protein produced by all nucleated cells at a constant rate freely filtered by the renal glomernli and almost entirely reabsorbed in the proximal tubule and its level in urine increases in cases with renal tubular dysfunction. Aim: The aim of the present study was to assess the urinary Cystatm C excretion in diabetic children attending the pediatric department of the National Institute of Diabetes and Endocrinology [NIDE] in comparison with apparently healthy children with comparable age and sex

Methods: We studied 60 children and adolescents [38 Females and 22 Males] with type 1 diabetes. They had a mean age of 13.93+/-2.92 years ranging from [10-18] years and a mean duration of 6.67+/- 3.35 years of diabetes. In addition to 30 healthy children and adolescents included as a control group, fourteen of them were females and 16 were males having a mean age of 14.731 2.13 years with the age range of [10- 18] years. All subjects were subjected to full history taking and thorough clinical examination with special emphasis on diabetic details and complications and an investigations including Microalbuminuria detected by measuring the albumin in urine by turbid metric method and urine creatinine by colorimetric measure and represented by [[A/C] ratio] also urinary Cystatin C excretion by ELISA from a morning urine sample was tested

Results and Conclusion: High urinary Cystatin C levels were present in 41 diabetic patients and none of the control group and were positively correlated to HbAlc and microalbuminuria [MA]

Study the relationship betweeen intercellular adhesion molecules [ICAM] and insulin resistance among type 2 Egyptian diabetic patients with nephropathy

Type 2 Diabetes is the common form of diabetes accounting for 90% of diabetic cases. As the incidence of type 2 diabetes is increasing the development of diabetic nephropathy. Nephropathy is one of the serious long-term complications of diabetes and may develop in 30-40% of diabetes mellitus patients. Endothelial inflammation has been implicated in the development of diabetic nephropathy. Type 2 diabetic patients usually present endothelial dysfunction. Reduction of endothelial function in type 2 diabetic patients stimulates inflammation and increases the levels of circulating soluble adhesion molecules [Intercellular adhesion molecules [ICAM]]. Cell adhesion molecules are important in promoting the inflammatory response. The aim of the present study is to determine plasma concentration of ICAM-1 as a marker for endothelial activation among type 2 diabetic patients with or without nephropathy [as tool in early diagnosis of nephropathy as major diabetic complications] also to explore the relationship between plasma level of ICAM-1 and insulin resistance in the studied patients. This study includes 70 subjects; 50 patients with type 2 diabetes mellitus were divided into two groups; First group consisted of 20 type 2 diabetic patients without complications. The second group comprised 30 type 2 diabetic patients with nephropathy. The third group [healthy controls] includes 20 non-diabetic subjects without a family history of diabetes mellitus. The results show that the mean sICAM-1 level was significantly higher in the diabetic patients with nephropathy than in those without nephropathy and in the controls .Also insulin level increase in diabetic patients than control. In addition positive correlation between ICAM-1 and insulin resistance in studied subjects. It can be concluded that the association between ICAM-1 expression and insulin resistance found in this study is consistent with clinical evidence relating insulin resistance and inflammation and high levels of sICAM-1 suggest that sICAM-1 may play a role in the development of nephropathy in patients with type 2 diabetes mellitus and can be use as a marker for early diagnosis of nephropathy as a major diabetic complications

Diabetic nephropathy in type 2 diabetic patients attending the outpatient clinic of N.I.D.E: prevalence and risk factors

Diabetic nephropathy is the leading cause of end-stage renal disease [ESRD] worldwide, and it is estimated that 20% of type 2 diabetic patients reach ESRD during their lifetime [2]. Incidence of diabetes in Egypt was estimated to be 9-11% [5]. Our study is the first large study which try to evaluate the prevalence of diabetic nephropathy and its risk factors in Egyptian diabetic patients. The study included 2651 type 2 Egyptian diabetic patients attending the outpatient clinics of N.I.D.E. Our results show that 74.2% of our patients [1968 patients] have chronic kidney disease. Stage 1 [normal GFR and urine abnormality] and stage2 [mild decrease of GFR] represent more than 88% of them. This is the stage where we can do our best to prevent renal failure. CKD patients have older age, longer duration of diabetes, higher systolic and diastolic BP, higher FBS, glycated Hb, triglycerides LDL, uric acid, waist circumference and low HDL compared with non CKD diabetic patients. As regard GFR, 8.9% [236 patients] of our patients have hypofiltration and 26% [689 patients] have hyperfiltration. There is an urgent need to launch a national diabetes control program to tackle the potential economic burden due to diabetic nephropathy in Egypt

Serum ferritin levels in poorly- and well-controlled diabetes mellitus

Serum ferritin level is related to body iron stores and is influenced by several diseases. This study was performed to evaluate the association between serum ferritin concentration and the complications and nature of diabetes mellitus [DM]. We examined association of ferritin concentration, fasting and postprandial glucose levels and glycated hemoglobin in 120 patients with type 2 diabetes mellitus and 50 healthy controls. We confirmed that serum ferritin was increased in diabetic patients as long as glycemic control is not achieved. There was also a correlation between ferritin level and diabetic neuropathy. This study showed an independent positive association between serum ferritin concentration and markers of glucose homeostatsis

Serum ferritin levels in poorly- and well-controlled diabetes mellitus

Serum ferritin level is related to body iron stores and is influenced by several diseases. This study was undertaken to evaluate the association between serum ferritin concentration and the complications and nature of diabetes mellitus [DM]. We examined association of ferritin concentration, fasting and postprandial glucose levels and glycated hemoglobin in 120 patients with type 2 diabetes mellitus and 50 healthy controls. We confirmed that serum ferritin was increased in diabetic patients as long as glycemic control is not achieved. There was also a correlation between ferritin level and diabetic neuropathy. This study showed an independent positive association between serum ferritin concentration and markers of glucose homeostatsis

Dysregulation of the fibrinolytic system in normal glucose tolerant offspring of type 2 diabetic patients

Impaired fibrinolysis increases the risk of cardiovascular diseases and favors the intravascular deposition of fibrin. Fibrinolysis is regulated through plasminogen activators, and especially inhibitors, primarily the plasminogen activator inhibitor-l [PAI-l]. First-degree relatives of type 2 diabetic subjects are supposed to be genetically prone to the development of clinical disease. It might be possible that hemostatic dysregulalion may be present even in normal glucose tolerant first-degree relatives. In the present study, we aimed to investigate the hemostatic parameters, including tissue plasminogen activator [tPA], fibrinogen, PAI-l antigen, and PAI-l activity, in a group of diabetic patients offspring in comparison with healthy control subjects who have no family history of diabetes. We also investigated relationships between these parameters and plasma insulin levels. We studied 40 nondiabetic offspring of type 2 diabetic population. There were 25 normoglycemic subjects without a family history of diabetes who served as the control group. Fasting and post-load insulin concentrations were significantly higher in the offspring group compared with those in the control group. Plasma fibrinogen and LPA antigen concentrations were comparable between offspring and control subjects. Plasma PAI-l antigen concentration was higher in offspring compared with control subjects. Similarly, plasma PAI-l activity was significantly higher in offspring compared with control subjects. Plasma PAI-l activity was positively correlated with plasma PAI-l antigen and fibrinogen concentrations. PAI-l activity also had an inverse correlation with HDL cholesterol concentration, and was significantly correlated with the Waist Hip Ratio [WHR], plasma fibrinogen, plasma tPA antigen, and HDL cholesterol. These data suggest that none obese normal glucose tolerant offspring of type 2 diabetic subjects have elevated PAI-l activity indicating to hypofibrinolysis. Despite the presence of hyperinsulinemia and, possibly, insulin resistance, there is no association between insulin levels and PAI-l activity in these subjects. Hypofibrinolysis associated with enhanced PAI-l activity may be a risk factor for early development of atherosclerosis in these subjects who are genetically prone to the development of diabetes in the future. Large-scale controlled studies are required to elucidate whether the increased prevalence of cardiovascular diseases present even at the diagnosis of overt diabetes is related to hypofibrinolysis, in the prediabetic state

Detection of antigliadin antibodies [AGA] as a serological marker of silent celiac disease among young type 1 diabetic Egyptian patients

This work aimed to study the prevalence of serum AGA-IgA [immunoglobulin] as a marker of celiac disease [CD] in 150 asymptomatic young type 1 diabetic patients. The control group consisted of 100 healthy comparable subjects. Both groups had no gastrointestinal symptoms. They were subjected to full history taking, thorough clinical examinations, full laboratory investigations including the estimation of AGA-IgA using ELISA method. The results showed that seven type 1 diabetic patients were positive for AGA, while there were no positive AGA cases among the control group. Six out of seven positive AGA patients showed villous atrophy after doing intestinal biopsy. The level of serum AGA was not correlated to age, fasting as well as postprandial blood glucose levels, glycated HbA1c, microalbuminuria and duration of diabetes. It was concluded that in young type 1 diabetic patients, the prevalence of CD is higher than that in general population