Role of plasma homocysteine concentration in type-1-diabetes with and without nephropathy

To determine the plasma level of total homocysteine [tHcy] as a marker of endothelial cell dysfunction and to investigate its possible role in type I diabetes [IDDM] with nephropathy. A randomized group comparative and cross sectional study. A total of 60 type I diabetic patients, 40 of them were complicated with nephropathy.20 patients without complication [s] and 20 healthy control subjects matched for sex and age. Suez Canal University Hospital. Fasting plasma concentration of tHcy was estimated by immunoenzymatic assay, hemoglobin was measured by affinity chromatographic method. Albumin excretion rate was determined by immunturbidometric method. Fasting blood glucose was determined by glucose oxidase method and serum creatinine was measured by alkaline picrate method. Type 1[IDDM] patients with nephropathy showed a significant increase of the fasting plasma tHcy levels compared to controls and those patients without complications. A significant positive correlation was observed between fasting tHcy and albumin excretion rate [AER] in patients with diabetic nephropathy. Also tHcy had positive significant correlation with serum creatinine and HbAlc. Meanwhile there was no significant correlation between tHcy and the following parameters, age, duration of diabetes and body mass index [BMI]. tHcy was increased in type I diabetic patients with nephropathy, tHcy was significantly correlated to AER, serum creatinine and HbAlc in type I diabetic patients with nephropathy tHcy contribute to enhanced rate of vascular complications observed in type I diabetic patients, tHcy can be an important risk factor that worsen prognosis

Role of plasma vascular endothelial growth factor [VEGF] in type-2 diabetes mellitus, with and without nephropathy, and its relation to glycemic control

To determine the plasma concentration of vascular endothelial growth factor [VEGF] and to investigate its possible role in diabetic nephropathy. A randomized, group comparative, and crossectional study. A total of 50 type-2 diabetic patients, 30 of them were complicated by nepthropathy, and other 20 diabetic patients without nephropathy, and 20-matched of non-diabetic control subjects. Suiz Canal University Hospital. Plasma concentration ol' VEGF, HbAlc, plasma glucose, albumin excretion rate [AER], and serum creatinine. The type-2 diabetic patients with and without nephropathy had plasma level of VEGF significantly higher than that of controls. Diabetic patients with nephropathy had significantly higher plasma level of VEGF than that of diabetics without nephropathy. Significant positive correlations exist between the plasma concentration of VEGF and fasting, 2-h postprandial blood glucose, glycosylated hemoglobin [HBAIc], and AER. VEGF may play an important role in mediating diabetic nephropathy

Microalbuminuria and endothelial dysfunction in hypertensive patients with and without cerebral lacunar infarctions

This study included 14 nondiabetic persons with untreated essential hypertension and cerebral lacunar infarctions detected by MRI or CT brain scan, 12 age and sex matched untreated nondiabetic hypertensive patients without infarction and 11 normal controls. Urinary albumin excretion [UAE] was measured photometrically and von Willebrand factor [vWF] as a known marker of endothelial dysfunction was estimated by a platelet aggregation method. UAE was found to be significantly higher in hypertensives with lacunar infarctions compared with those without and to normal control. VWF concentrations were found to be significantly higher in patients with lacunar infarctions compared with those without and with the normal control, but there was no significant difference between its level in hypertensives without lacunae and the normal controls. There was a significant positive linear correlation between vWF and UAE values in hypertensive patients with lacunar infarctions. Increased systolic blood pressure and low HDL correlated with both UAE and vWF in patients with lacunar infarctions

Uninary aibumin excretion rate in patients with type 2 diabetes mellitus and retinopathy

To determine whether a relationship between retinopathy and nephropathy in patients with type 2 diabetes mellitus; 47 subjects with type 2 diabetes mellitus and retinopathy, and a control group formed of 65 subjects with type 2 diabetes mellitus but without retinopathy were examined for urinary albumin excretion per 24 hour, fasting blood glucose, 2 hour post prandial blood glucose, glycosylated HbA1c, fasting serum cholesterol, fasting serum triglycerides, blood urea, serum creatinine and glomerular filtration rate The two groups of patients were matched for age and sex. They were above 5 years diabetes duration and had a within normal renal function. Results of this study showed that subjects with diabetic retinopathy had mostly nonprolifertive type [41 [87.23%]] and there was an increase in their urinary albumin excretion per 24 hour [19 [40, 43%]] which was mainly in the form of microalbuminuria. Comparing the frequency and mean values of micro albuminuria and macro albuminuria in the two groups of patients, there was a significant increase in the diabetic subjects with retinopathy. Also, these patients had a significant increase in the mean values of fasting blood glucose, post prandial blood glucose, fasting serum cholesterol, fasting serum triglycerides, glycosylated HbAlc, diabetes duration and both systolic and diastolic blood pressure. For the other studied parameters, there was a non significant increase in the mean values of fasting serum insulin, blood urea, serum creatinine, glomerular filtration rate, body mass index and age of the patients in the diabetics with retinopathy in comparison to those without retinopathy. These results suggest that patients with type 2 diabetes mellitus and retinopathy have an increase in the rate of urinary albumin excretion and there is a strong association between background retinopathy and microalbuminuria. Consequently microalbuminuria can be considered as a risk factor for diabetic retinopathy as well as fundus examination can be a useful and rapid bed side diagnostic tool for diabetic nephropathy