الفهرس 
Chronic obstructive pulmonary diseaseOnly 14 pages are availabe for public view
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Abstract
Chronic Obstructive Pulmonary Disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients. Diabetes mellitus (DM) is a group of metabolic diseases of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action or both. Diabetes mellitus (DM), especially type 2, represents one of the most important health problems worldwide. Type 2 diabetes ranges from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance and accounts for 90–95% of those with diabetes. This form of diabetes, previously referred to as non–insulin dependent diabetes, type 2 diabetes, or adult-onset diabetes, encompasses individuals who have insulin resistance and usually have relative (rather than absolute) insulin deficiency. Patients of type 2diabetes are at increased risk of developing macrovascular and microvascular complications. COPD may be considered as a novel risk factor for T2DM via multiple pathophysiological alterations such as: inflammation, oxidative stress, administration of glucocorticoids, insulin resistance and weight gain. On the other hand, diabetes may act as an independent factor, negatively affecting pulmonary structure and function. Diabetes is associated with an increased risk of pulmonary infections, disease exacerbations and worsened COPD outcomes. SP-D plays a critical role in innate host defense of the lung. SP-D binds bacterial, fungal, and viral pathogens, enhancing their opsonization and their killing by alveolar macrophages. SP-D is thought to play an important role in the pathogenesis of COPD by oxidant production, inflammatory responses in alveolar macrophages and apoptotic cell clearance. SP-D could be behind the association of lung function with impaired insulin action .The lung innate immunity, as inferred from circulating SP-D concentrations, is at the cross-roads of inflammation, obesity, and insulin resistance. The current study was carried out at the Medical Biochemistry and Chest diseases and Tuberculosis Departments, Faculty of Medicine, Menoufia University. The aim of this work was to study the possible role of SP-D in the association of COPD with T2DM. Full history, general examination, local chest examination, estimation of body mass index and spirometric measurements were made to every subject. Laboratory investigations were also carried out to all individuals including: fasting blood glucose (FBG), glycated haemoglobin (HbA1c) and serum surfactant protein D (SP-D) level.