الفهرس 
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Abstract
SUMMARY
Diabetes mellitus is often accompanied by dyslipidemia and dysfunction in glucose and protein metabolism. Diabetes is associated with a two- to fourfold excess risk of coronary heart disease. Although the degree of glycaemia in diabetic patients is strongly related to the risk of micro vascular complications (retinopathy and renal diseases), the relation of glycaemia to macro vascular disease in type II diabetes is more modest. There are studies that have reported abnormal carnitine metabolism in diabetes. The synthesis of L-carnitine requires two essential amino acids (lysine and methionine), iron, and vitamins C, B6 and niacin in the form of nicotinamide dinucleotide.
Carnitine is synthesized primarily in the liver and also in the kidney, and must be transported to other tissues. It is most concentrated in tissues that use fatty acids as their primary dietary fuel, such as skeletal and cardiac (heart) muscle. Carnitine acyltransferases have crucial functions in fatty acid metabolism. Members of this enzyme family show distinctive substrate preferences for short-, medium- or long-chain fatty acids. The molecular mechanism for this substrate selectivity is not clear because so far only the structure of carnitine acetyl-transferase has been determined.
Carnitine deficiency may be primary or secondary. Factors such as sex, age, nutritional status, fasting and disease have been cited as influencing plasma carnitine levels in man. Plasma carnitine levels have been found to be normal or decreased in studies on carnitine metabolism in diabetes mellitus patients.
L-carnitine has been demonstrated to bear anti-inflammatory and antioxidant properties and improves insulin sensitivity, protein nutrition, dyslipidemia, and membrane stability. Due to its pivotal role in intermediary metabolism, it is not surprising that plasma and tissue levels of L-carnitine are maintained within a relatively narrow homeostatic range which is controlled by carrier mediated gastrointestinal absorption from dietary sources, endogenous biosynthesis, extensive renal tubular reabsorption, and compartmentalization through carrier-mediated transport between plasma and tissue.
The aim of this study was to detect serum level of l-carnitine in insulin dependent diabetes (type1D) and compare with other healthy age and sex matched children.
This was a case control study estimating serum level of L-carnitine in insulin dependent diabetes in school age children and healthy children was conducting at outpatient clinic at Beni-Suef university hospital. Participants were divided into two groups; group (A): (20) school age children had insulin dependent diabetes (cases) recruited from outpatient clinic, Beni-Suef University hospital. group (B): (20) matched age and sex school age children as healthy controls.
The main results of the study revealed that:
In group A there were 11(55%) male, 9(45%) female, the mean age 9.1(± 2.1 SD) with range (6-12), In group B there were 9(45%) male, 11(55%) female, the mean age 8.75(± 2.2SD) with range (6-12). There was no significant difference between 2 groups.
In group A , the mean BMI 15.5(± 1.19 SD) with range (13.3-17.7), In group B the mean BMI 16.79(± 1.07 SD) with range (15-19). There was high significant difference between 2 groups as regard BMI.
There was high significant difference between 2 groups as regard Fasting plasma glucose, as regard Oral glucose tolerance test and as regard HbA1C.
In group A the mean L-Carnitine 1343.0 (±1111.5 SD) with range (151.7-3680.0), In group B the mean L-Carnitine 2467.98(±869.78 SD) with range (1086.5-4393.5), There was high statistically significant difference between 2 groups.
Based on our findings, we recommend for further prospective studies on larger sample size to emphasize our conclusion.