الفهرس 
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Abstract
Background: Patients with type 1 diabetes develop microangiopathic
complications, which are responsible for morbidity in adulthood. It had
been widely known that diabetes is associated with alteration in
extracellular matrix (ECM) synthesis. Matrix metalloproteinases (MMPs)
can potentially contribute to many microvascular and macrovascular
complications of diabetes. MMP-2 is responsible for ECM breakdown
and their abnormal circulating levels may pre-date clinical evidence of
diabetic angiopathy.
Aim of the work: is to evaluate the level of matrix metalloproteinase 2,
as a serum marker for diabetic vascular diseases, and its activity in
adolescents and adults with type 1 diabetes mellitus and in diabetic
nephropathy.
Subjects and methods: This study included 60 subjects divided into
three groups. Group I: included 20 healthy adolescents. Their ages
ranged between 17-35 with a mean of 2 5.86±1.86 .Group II: included 20
adolescents and adults with diabetes duration ranging from 1.5 years to
4.5 years with a mean of 3.08±0.91 years. Their ages ranged between 17-
35 years with a mean of 22.4±6.69 years. Group III: included 20
adolescents and adults with diabetes duration ranging from 5 to 21 years
with a mean of 8.6±3.97 years. Their ages ranged between 18-35 years
with a mean of 27.0±5.06 years. All patients and controls were subjected
to history taking, thorough clinical examination and laboratory
investigations included; random blood sugar, glycosylated hemoglobin
(HbA1c), quantitative determination of urinary microalbuminuria and
measuring of matrix metalloproteinase-2 levels (using ELISA) and
activity.
Results: Highly significant difference between group I and group II as
regards their random blood glucose HbA1c, being higher in group II.
Highly significant increase in MMP2 level in group III when compared
with group I (p<0.001). Highly significant increase in MMP2 level in
group III when compared with group II (p<0.001). MMP2 was
significantly higher in group II in comparison with group I (p<0.001). No
significant correlation was found between MMP-2 levels and age, disease
duration random blood glucose and HbA1c in group II (p>0.05).Positive
significant correlation was found between MMP-2 levels and age, disease
duration, random blood glucose and HbA1c in group III (p<0.05).
Conclusion: MMP-2 concentrations are increased in type 1 diabetic
patients, elevated MMP-2 levels and activity could be usefull as a
screening marker of diabetic nephropathy and were correlated with
parameters of metabolic control and disease duration.