ABSTRACT
Hyperglycemia is associated with excessive non-enzymatic glycosylation of the glomerular matrix thus contributing to the pathogenesis of diabetic nephropathy. Matrix metallopoteinases [mmp[s]] are responsible for matrix degradation. This study was conducted to unvestigate the potential diagnostic value of serum levels of two of the known mmp[s]], namely mmp-1 and mmp-2 in type ii diabetes and their relationship to vascular complications. This study was concluted on 30 female type ii niddm diabetes mellitus [dm] patients recruited from the diabetic clinic, kasr al aini hospital, cairo university. A control group including 10 apparently healthy age matched females with no family history of diabetes was also studied. All patients were subjected to full history taking and full clinical examination. Laboratory investigations included fasting blood sugar, liver function tests, kidney functions, lipid profiles, glycosylated hemoglobin, according to which, patients were divided into 2 groups, fairly and poorly controlled and microalbuminuria, according to which, patents were divided into with and without diabetic nephropathy. Mmp-1 and mmp-2 were measured using an elisa technique. The ages of the patients under study ranged from 40-55, with a mean of 48.83 +/- 4.36. The duration of diabetes ranged between 1-20 years with a mean of 110-170 with a mean of 129.33 +/- 18.56 and their diastolic blood pressure ranged from 60-110 with a mean of 79.33 +/- 8.68. The mean serum mmp-1 level was significantly higher 16.63 +/- 9.13 and 5.48 +/- 2.37 respectively [p= < 0.01]. Mmp-1 was significantly higher in patients with nephropathy compared to controls, however it was significantly decreased than its mean value in patients without nephropathy 14.3 +/- 8.55 and 21.3 +/- 8.83 respectively [p= < 0.05]. The mean serum mmp-1 level was significantly higher in the poorly controlled and fairly controlled diabetics [16.71 ng/ml +/- 9.23 and 16.52 ng/ml +/- 9.37] as compared to the control group [5.48 ng/l +/- 2.37] [p= < 0.01]. The mean serum mmp-1 was significantly higher in the hypertensive group compared with control group 13.49 +/- 8.52 and 5.48 +/- 2.37 respectively [p= < 0.01]. On the other mean serum mmp-2 level was significantly reduced in hypertensive cases compared to the non-hypertensive ones 197.4 +/- 56.76 and 24.741 +/- 57.53 respectively [p= < 0.05]. The mean mmp-2 levels also showed a positive correlation with the diastolic blood pressure [r=0.756, p< 0.01]. Mmp-1 serum levels may be implicated in the complications of DM