الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 149 |  |  |
| | | from | 149 | | |
Abstract
Diabetic nephropathy is one of the most serious complications
of diabetes and the appearance of pathological levels of urinary
albumin excretion represents the most reliable diagnostic test of early
renal involvement in patients affected by diabetes mellitus.
Liver-type fatty acid-binding protein (L-FABP) is expressed in
the proximal tubules of the human kidney and participates in fatty acid
metabolism. In one clinical study, urinary excretion of L-FABP was
reported to offer potential as a clinical marker to screen for kidney
dysfunction and thereby identify patients who are likely to experience
deterioration of renal function in the future.
Tubular hypoxia up regulated the expression of the L-FABP
gene in the kidney and increased the urinary excretion of L-FABP
from the proximal tubules. Thus, in early-stage diabetic nephropathy,
it is possible that chronic hypoxia could have induced an increase in
urinary excretion of L-FABP.
The current study aimed to evaluate the L-FABP level as an
early biomarker of diabetic nephropathy in type 2 diabetic patients.
This work performed on (60) patients with diabetes mellitus
type 2,(30) patients non diabetic with chronic kidney disease (CKD),
and (30)apparently healthy subjects working as control.
Candidates of the present study were subjected to clinical
evaluation and determination of fasting blood sugar, post brandial
blood glucose, urea, parathyroid hormone, calcium, estimation of
glomerular filtration rate, estimation of albumin creatinine ratio, serum creatinine, HbA1c, lipid profile, albumin creatinine ratio and
urinary L-FABP by (ELISA).
The results of the present work showed that:-
The duration of diabetes in diabetic patients with macro
albuminuria was statistically significant longer than in both
normoalbuminuric and micro albuminuric diabetic patients.
Patients with micro albuminuria was statistically significant
longer than in normoalbuminuric diabetic patients.
Fasting blood sugar and HbA1c was significantly higher in
patients with advanced stage of diabetic nephropathy
(macroalbuminuric diabetic patients) compared to
normoalbuminuric diabetic patients and microalbuminuric
diabetic patients.
A significant increase of serum T.cholesterol, triglecyride,
LDL-C in diabetic patients with macroalbuminuria compared to
normoalbuminuric diabetic patients and microalbuminuric
diabetic patients.
A significant increase of serum creatinine in diabetic patients
with macroalbuminuria compared to normoalbuminuric diabetic
patients and microalbuminuric diabetic patients.
Urinary microalbumin was significantly higher in
microalbuminuric diabetic group and macroalbuminuric
diabetic group compared to normoalbuminuric diabetic group
and in diabetic patients with macroalbuminuria was
significantly higher in diabetic patients with microalbuminuria.
A significant increase of ACR in diabetic patients with
microalbuminuria and diabetic patients with macroalbuminuria
compared to the normoalbuminuric diabetic group.
patients and microalbuminuric diabetic patients.
A significant increase of urinary L-FABP level in
microalbuminuric diabetic patients compared to
normoalbuminuric diabetic patients and in normoalbuminuric
diabetic patients compared to control subjects.
A significant positive correlation between urinary L-FABP
level with the duration of diabetes, fasting blood glucose,
HbA1c, triglyceride and ACR. Urinary L-FABP level values
showed a significant negative correlation with HDL-C.