الفهرس 
Diabetes mellitus
Type 1 Diabetes mellitusOnly 14 pages are availabe for public view
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Abstract
Type 1 diabetes mellitus (T1DM) is a chronic, lifelong
disorder of glucose homeostasis characterized by
autoimmune destruction of the insulin-producing pancreatic
b-cell, leading progressively to insulin deficiency and
resultant hyperglycemia. Its incidence continues to increase
worldwide and it has serious short-term and long-term
implications. These complications consist of microvascular
and macrovascular disease, which account for the major
morbidity and mortality associated with T1DM.
Screening provides an opportunity to detect uNGAL
early to initiate therapy, and to encourage meticulous
attention to achieving glycemic goals during the reversible
phase of diabetic nephropathy which is the single leading
cause of end-stage renal disease and the need for renal
replacement therapy and considered one of the most severe
microvascular complications in patients with type 1
diabetes.
Urinary NGAL is currently considered as one of the
most promising biomarkers in clinical nephrology and has
been extensively studied in acute kidney disease. Acute
kidney disease is closely related to high morbidity and
mortality. Therefore, researchers had aggressively searched
for a new biomarker and uNGAL has been found to
improve the accuracy of the current biomarkers used toThe aim of this case control study was to assess
urinary neutrophil gelatinase-associated lipocalin (uNGAL)
in type 1 diabetic adolescents and to evaluate urinary
NGAL as an early marker for diabetic nephropathy on 90
adolescents (44 males and 46 females) divided into three
groups: group I included 30 of type 1 diabetic adolescents
with microalbuminuria, group II included 30 of type 1
diabetic adolescents without microalbuminuria and group
III included 30 of apparently healthy age and sex matched
adolescents as a control group.
All patients and controls were subjected to full history
taking, growth assessment using Egyptian growth curves,
vital signs including blood pressure (BP), head and neck
examination, systemic examination and laboratory
investigations (complete urine analysis with culture, serum
urea and serum creatinine, albumin/creatinine ratio will,
glycosylated hemoglobin (HbA1c) and Urinary NGAL
concentration.
Our results showed that;
There was no significant difference between three groups
for the gender, BMI, height, age and age on set between
three groups but there was a significant longer duration in
group II than group I (p=0.003). Also, there was a
significant difference between group I and group II for
SBP and DBP as it was higher in group I (p=0.000).The present study showed the statistical difference
between the diabetic patient groups I or II and the control
group as regards glycosylated hemoglobin (HbA1c) and
FBG as it was higher in group II (p=0.000). Also, there was
a highly statistically significant difference in the mean±SD
between the collective patient groups I and II for Insulin
Dose u/kg/day (p=.031).
Liver enzymes have been tested for all groups to
ensure that they have not liver disease. According to ALT
and AST results, the patients with highly ALT and AST
were excluded from this study so that there is no significant
difference between patients group I, group II and Group
III normal control.
This study showed the statistical difference between
the diabetic patient groups and the healthy group as regards
lipid profile as there was a statistically significant
difference in the mean±SD of Total cholesterol was
significantly higher in group II the patients groups
compared the group III. Also, there was a significant
difference between mean±SD of HDL, LDL and
triglycerides for T1DM group II compare to group III
healthy control. On the other hand, there was a significant
difference between mean±SD of triglycerides for T1DM
group I compare to group III and between HDL-C for
T1DM group I compare to group II.
Our study showed there was a highly statistically
significant difference in the mean±SD of creatinine and eGFR between T1DM with nephropathy patient groups and
control. On the other hand, there was no a significant
difference between the diabetic patient groups and the
healthy group in the mean±SD urea or between patient’s
groups.
This study showed there was a highly statistically
significant increase in the mean±SD Albumin Creatinine
Ratio (ACR) in group II T1DM with nephropathy patient
groups compared to controls.
Current study showed there was a highly statistically
significant increase in the mean±SD Albumin Creatinine
Ratio and uNGAL in group II T1DM with nephropathy
patient groups compared to controls.
The mean value of uNGAL was higher in diabetics
with positive family history of diabetes mellitus than in
group I and group II diabetics with negative family history
of diabetes and the difference was statistically significant.
The mean value of uNGAL was higher in diabetics
with positive family history of Cardiovascular disease than
in group I and group II diabetics with negative family
history of diabetes and the difference was statistically
significant.
The mean value of uNGAL was higher in diabetics
with positive family history of Renal disease than in Group
I and group II diabetics with negative family history of
diabetes and the difference was statistically significant The mean value of ACR was lower in diabetics with
positive family history of Cardiovascular disease than in
group I and group II diabetics with negative family history
of diabetes and the difference was statistically nonsignificant.
The mean value of ACR was higher in diabetics with
positive family history of Renal disease than in group I and
group II diabetics with negative family history of diabetes
and the difference was statistically significant.
There was a significant positive correlation of SBP,
DBP, Triglycerides and uNGAL. On the other hands, there
was non-significant positive correlation between Urea and
uNGAL and negative non-significant correlation between
Liver Function, eGFR and uNGAL.
detect kidney damage.