Expression of apoptosis in diabetic nephropathy in patients with insulin dependent diabetes mellitus [IDDM]

ABSTRACT

The present study was designed to determine the level of bcl-2 as apoptotic modifiers in diabetic nephropathy of IDDM patients. Simultaneous determination of urinary N-acetyl glucoaminidase [NAG], beta 2-microglobulin [beta 2-MG] and microalbuminuria as indicators of early nephropathy in IDDM. Twenty-six children with IDDM and nephropathy in addition to 18 healthy control were involved in this study. They were chosen among those attending the pediatric department of EI-Minia university hospital. All patients were subjected to careful clinical, radiological and ultrasonographic examinations. Blood samples were taken at the clinic for random glucose determination by the glucose oxidase method and serum fructosamine assay. Plasma bcl-2 was determined by bcl-2 endogene human ELISA kits supplied by endogene corroborating, MA USA. NAG activity was determined photometrically. Twenty ml random urine sample was also collected from all subjects between 11 a.m. to 2 p.m. Urine sample from patients were stored at-20 ° until used for beta2-MG determination by ELISA technique. Urinary creatinine was determined by the method of Bonsens and Taussky. The healthy controls consisted of 18 volunteers matched in age and sex, with negative albuminuria by Albustix test, were subjected to the same investigations as the patients group. Our results proved that in IDDM patients, serum NAG, urinary NAG, NAG / creatinine, beta2-MG/creatinine and bcl -2 all were significantly increased compared to controls [P< 0.001]. Blood fructose level and urinary beta2-MG were also significantly increased [P < 0.05]. It was concluded that the assessment of bcl2, serum. NAG, urinary NAG and urinary beta2-MG are easily and accurate test for showing the glomerular and tubular renal damage in IDDM