relation between the serum level of tumor necrosis factor-alpha and grade of retinopathy in Egyptian type 2 diabetic patients

Diabetes mellitus causes metabolic and physiological abnormalities in the retina suggestive the role of inflammation in the development of diabetic retinopathy. Tumor necrosis factor [TNF]-alpha is a pleiotropic cytokine implicated for early inflammatory changes seen in the diabetic retina. A strong correlation between the serum levels of TNF-o and the severity of diabetic retinopathy has been described. The aim of this study is to estimate the serum levels of TNF-o in Egyptian type 2 diabetic patients with different grades of retinopathy and correlating these levels to the grade of retinopathy. Eighty subjects participated in the study and they were classified into four groups; group [A] with type 2 diabetes but no retinopathy, group [B] with non proliferative type 2 diabetic retinopathy, group [C] with proliferative type 2 diabetic retinopathy and group [D] which was a control group of subjects matched for age and sex with the other groups. The study revealed a progressive elevation of serum TNF-alpha in e 2 diabetic patients according to the progression of retinopathy and that the serum levels of TNF-alpha were significantly correlated with the grade of retinopathy which was also significantly correlated with age and duration of diabetes but not with sex. A common feature of a number of new therapies for diabetic retinopathy is inhibition of the production of inflammatory mediators

Serum interleukin 8 concentrations in obese subjects with and without impaired glucose tolerance

Interleukin 8 [IL-8] is a cytokine with atherogenic properties. Studies revealed that it is produced and secreted by human adipocytes. The aim of the present study is to evaluate serum IL-8 concentrations in obese subjects with normal glucose tolerance [NGT] and in obese subjects with impaired glucose tolerance [IGT] in fasting state and after oral glucose tolerance test [OGTT] and to find any relation between serum IL-8 and BMI, WHR and glucose level. A total of 60 subjects with marked overweight or obesity [BMI >27.8kg/m[2]], without previously diagnosed disturbances of glucose tolerance, were included in the present study. They were divided into two groups. Group I included 30 subjects with NGT [13 men and 17 women] and group 2 included 30 subjects with IGT [11 men and 19 women]. 25 sex and age-matched healthy lean volunteers were included as control group. In the fasting state, there was no significant difference in fasting serum IL- 8 concentrations between group I and group II. However, fasting serum IL-8 level was significantly higher in both groups in relation to control lean group [p<0.05 and <0.05 respectively]. After OGTT, serum IL-8 level showed no significant differences in lean group [p>0.05] and a highly significant increase in-group I and II [p<0.001]. There was a highly significant increase in serum level of IL-8 after OGTT in-group I and II in relation to control group [p< 0. 01 and <0.001 respectively]. There was also a highly significant increase in serum level of IL-8 in-group II when compared with group I [p<0.01]. In both groups fasting serum IL-8 was related to BMI [group I, r=0.919, p<0.00l; group 2, r=0.843, p<0.001], and also to WHR [group I, r=0.758, p<0.01; group II, r=0.641, p<0.05]. There were no significant correlations between fasting serum IL-8 and plasma glucose level in studied groups. Serum IL-8 concentrations after OGTT were positively related to post load glucose level [r= 0.83, p< 0.001], in group II, but not in group I. We conclude that fasting serum IL-8 levels are increased in obese subjects with normal and impaired glucose tolerance, and are related to BMI and WHR after OGTT, serum IL-8 levels are related to glucose level in obese subjects with IGT. It is possible that an increase in circulating serum IL-8 level might be one of the factors linking obesity and prediabetic stage with greater cardiovascular risk

relation between the serum hepatocyte growth factor and carotid atherosclerosis in Egyptian patients with essential hypertension

The aim of this study was to evaluate the relationship between the serum hepatocyte growth factor [HGF] and carotid intima media thickness [IMT] in Egyptian hypertensive and non-hypertensive subjects. The study revealed a highly significant increase in serum HGF and IMT in hypertensive patients compared with non-hypertensive subjects. There was a significant positive correlation between the carotid IMT and the mean duration of hypertension, systolic and diastolic blood pressure, smoking, age, sex, serum total cholesterol, serum triglycerides, serum low density lipoprotein and serum HGF, with significant negative correlation with serum high density lipoprotein in hypertensive patients. In hypertensive patients, there was a significant positive correlation between serum HGF and age, sex, mean duration of hypertension, systolic and diastolic blood pressure, smoking, serum total cholesterol, serum triglycerides, serum low density lipoprotein and IMT, with a significant negative correlation with serum high density lipoprotein. Angiotensin converting enzyme inhibitors are recommended to be used in the treatment of hypertension as they improve endothelial dysfunction by stimulating the local production of hepatocyte growth factor leading to inhibition of neointimal formation

Estimation of serum and vitreous levels of soluble Fas and soluble Fas ligand in Egyptian insulin dependent diabetic patients with neuropathy or retinopathy

Apoptosis is a physiological process observed in many organs and cells which may also occur in pathological conditions. The most important mechanism of apoptosis is the Fas- system. Beta-cell apoptosis has been associated with the onset of insulin dependent diabetes mellitus. The aim of this work is to estimate the serum and vitreous levels of soluble Fas [sFas] and soluble Fas ligand [sFasL] in insulin dependent diabetics with retinopathy and the serum level of s.Fas and s.FasL in insulin dependent diabetics with neuropathy and to compare the results with those obtained from non diabetic and non complicated diabetic subjects. The study revealed a significant increase in the vitreous and serum levels of sFas and sFasL in diabetic patients with retinopathy and a more significant increase of the serum level of sFas and sFasL in diabetics with neuropathy. So, the disregulation of the Fas system may be one of the mechanisms of the pathogenesis of diabetic complications and complementary studies are required to treat or prevent the occuranc of these complications

Serum level of vascular endothelial growth factor in coronary artery disease Egyptian patients with and without diabetes mellitus

Coronary collateral blood vessels formation helps to preserve myocardial function in coronary artery disease as their presence reduces the degree of myocardial ischemia and functional deficit. Vascular endothelial growth factor [VEGF] plays a significant role in this adaptive process. Diabetes mellitus decreases the expression of messenger ribodeoxy nucleic acid [mRNA] and protein for VEGF and its receptors in the myocardium, so diabetes mellitus is one of the first negative predictors of collateral vessel formation. The aim of this work is to estimate the level of serum VEGF in a group of non diabetic patients complaining of coronary artery disease and another group of non insulin dependent diabetic patients complaining of coronary artery disease and to evaluate the relation between diabetes mellitus and the level of VEGF in patients complaining of coronary artery disease in comparison to control group and to assess the relation of VEGF level to systolic and diastolic functions of the heart and to resting wall motion abnormalities in ischemic heart disease patients. In this study we measured the serum level of VEGF in 30 non diabetic patients with coronary artery disease, 30 non insulin dependent diabetic patients with coronary artery disease and 20 apparently healthy subjects matched for age and sex using enzyme immunoassay methods. The study revealed that as in non diabetic patients with coronary artery disease, there was a significant increase in the level of serum VEGF while in diabetic patients there was a significant decrease of the serum level of VEGF, so diabetes mellitus is considered a major risk factor for patients with coronary artery disease as it decreases the level of VEGF induced by myocardial ischemia which is very important for the formation of coronary collaterals. This effect was reflected on systolic and diastolic functions and wall motion abnormalities which were more significantly affected in type 2 diabetic patients and could be explained by reduced collateral vessel formation