الفهرس 
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Abstract
In this study, we aimed to evaluate urinary GAGs in patients with
type2 diabetes as a marker for diabetic nephropathy.
This study was conducted on a number of 60 patients (40 diabetic
and 20 non diabetic patients) and 20 healthy individuals. Patients were
selected from out patients and in patient clinics of Internal Medicine
Department, Minoufia University Hospital-Egypt during the period from
March, 2015 to July, 2015. Informed consent was obtained from all
participants who were be fully informed about the study according to
ethical medical committee of Menoufia University Hospital.
Subjects were divided into 4 groups:
group 1) 20 type 2 diabetic patients without proteinuria.
group 2) 20 type 2 diabetic patients, with proteinuria.
group 3) 20 non-diabetic patients with CKD.
Group4) 20 healthy subjects are included as a control group.
Exclusion criteria: Patients with chronic liver disease, chronic heart
failure, urinary tract infection, body mass index > 30 and recent infection.
All subjects were subjected to the followings:
Full history taking.
Complete clinical examination and measurement of body mass index.
Investigations :-
Routin investigations:
1. -Complete urine analysis.
2. C.B.C.
3. -Blood glucose level (fasting, 2hours post prandial) and HbA1c.
4. -Plasma lipid profile( T.cholestrol& T.Gs)
5. -The liver function test(SGOT,SPOT,P.T, Serum albumin, T.s. bilirubin)
6. -Renal function test (urea and creatinine).
7. -Glomerular filtration rate (GFR) :estimated by MDRD
8. -Urinary albumin/creatinine ratio
9. -Abdominal ultrasonography for kidney, liver, spleen and present or
absence of ascites.
Special investigations:
- Measurement of urinary heparan sulfate by Eliza.
Results showed:
-Increased urinary GAG excretion more significant in DM with
proteinuria than other patients and controls.
-Higher lipid profile (cholesterol, TGs) levels with DM and CKD
patients in comparison to the control group, and in DM with proteinuria
group higher than other groups.
-Increased HbA1c, FBG, and 2HPP in DM with proteinuria patients than
DM without proteinuria.
- Increased urea and creatinine and urinary Alb /creat ratio and
decreased eGFR in DM with proteinuria patients compared to DM
without proteinuria group.
-Positive correlation between (urea, creatinine and urinary Alb/creat
ratio) and urinary GAGs in DM with proteinuria.
- Negative correlation between (eGFR) and urinary GAGs in DM with
proteinuria.
- Positive correlation between urinary GAGs excretion and cholesterol,
triglycerides levels in DM with protinuria and -ve correlation in DM
without proteinuria and CKD.
Based on our results we concluded that DM patients with
proteinuria showed increased urinary GAGs excretion compared to nonproteinuric
diabetic and non-diabetic chronic kidney disease patients.
These results suggested that urinary GAGs could be useful markers in
early detection of proteinuric diabetic nephropathy in type 2 diabetic
mellitus patients.