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

relationship between urinary vascular endothelial growth factor and insulin like growth factor levels on diabetic nephropathy in patients with type 2 diabetes

Urinary Vascular endothelial growth factors [u VEGFs] as well as plasma insulin like growth factors [pIGFs] has been implicated in the pathogenesis of diabetes mellitus. This study was performed to determine whether alternations of urinary VEGFs and plasma IGFs are related to diabetic nephropathy in type 2 diabetic patients. We examined association of UVEGFs,pIGFs concentrations with fasting glucose level, glycemic control index [HbAlc%], urinary measured renal parameters i.e. creatinine, creatinine clearance and albumjnuria as well as lipogram parameters in 75 type 2 diabetic patients and 25 healthy controls. Study subjects were divided into four groups using urinary albumin to creahinine ratio [A/Cr]. We confirmed that [i] both urinary VEGFs and plasma IGFs showed remarkable increase in all diabetic groups with worsen A/Cr ratio, as compared with controls. [ii] Urinary VEGFs and plasma IGFs were increased in diabetic patients as long as glycemic control was not achieved [iii] Vascular endothelial growth factor in urine as well as plasma insulin like growth factors elevations were also revealed statistically direct positive correlation with glycemic control index, albuminuria as well as T.G.s elevation and HDL decreasing in lipogram parameters. Urinary VEGFs excretions as well as plasma IGFs increased during the earlier stage of diabetic nephropathy and were significantly correlated with urinary albumin excretion. This suggested that VEGFs may be used as a sensitive marker of diabetic nephropathy and for predicting disease progression