الفهرس 
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Abstract
The majority of diabetes related mortalities are due to renal complications.The early detection of renal complication is important in reducing mortality and morbidity from diabetic nephropathy. Prolonged hyperglycemia is now recognised as a major factor in the pathogenesis of nephropathy in diabetes.The Diabetic nephropathy is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli.
Endothelins are powerful vasoconstrictor peptides act through two types of receptors (ET-A and ET-B) and are expressed on endothelial cells,Activation of this receptor in renal cells leads to stimulation of mesangial cell hypertrophy ,proliferation,extracellular matrix accumulation.These hemodynamic renal alterations are associated with the onset and progress of renal disease in DM.
The current study aimed to assess the level of endothelin -1 in patients with type 2 DM as an early marker for diabetic nephropathy .
The study included 70 patients suffering from type 2 DM ,(44male and 26 female). The patients were divided according to the presence or absence of nephropathy into two groups :
Group 1: Included 35 cases were diabetic with nephropathy (22males and 13 females) their ages ranged from 45-75years, 34 cases of diabetes with nephropathy were hypertensive also. Group2: Included 35 cases were diabetic without nephropathy ( 22males and 13 femals) their ages ranged from 40-77 years , 17 cases of the diabetic without nephropathy were hypertensive also. In addition to eighteen apparently healthy individuals ,age and gender matched subjects were
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involved in control group( 13 male and 5 female). The ages of the control group ranged between 40-80 years.
In the present study all individuals were subjected to clinical evaluation and laboratory investigations in the form of fasting blood glucose ,HbA1c, s.creatinine, s.urea,microalbumin,and serum level of endothelin -1 (ET-1) .
*The results of the present work showed that:
There was no statistically significant differences among the studied groups (diabetic with nephropathy, diabetic without nephropathy and controls) regarding age,gender ,BMI &smoking (P>0.05).
There was statistically significant difference between the studied groups (diabetic with nephropathy, diabetic without nephropathy and controls) as regard SBP and DBP (P<0.001).
The mean differences between the whole studied groups (diabetic with nephropathy, diabetic without nephropathy and controls) of biochemical markers (HbA1c, microalbumin, eGFR ,s.creatinine and s.urea) were highly significant (P<0.001) .
The mean ET-1level were higher in diabetics compared to controls.There were a highly significant difference between the diabetic with nephropathy, and diabetic without nephropathy also between diabetic with nephropathy and control (P<0.001) but there were no statistical significant difference between the studied groups diabetic without nephropathy and control (P>0.001).
There was highly significant negative correlation between ET-1and eGFR and significant positive correlation between ET-1and microalbumin as regarding diabetic with nephropathy but there was
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no significant correlation between ET-1and eGFR, microalbumin as regarding diabetic without nephropathy and controls.
There was no significant correlation between ET-1and urea, creatinine, HbA1c & age as regarding diabetic with nephropathy, diabetic without nephropathy and controls.