الفهرس 
Diagnosis and Classification of Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Summary
Vaspin (a visceral adipose tissue-derived serine protease inhibitor) is a novel adipocytokine that was reported to be specifically expressed in VAT of Otsuka Long-Evans Tokushima Fatty (OLETF) rats.
Vaspin has recently been identified as novel adipokine with high expression in adipose tissue of obese and type 2 diabetic subjects and with potentially insulin sensitizing properties .
Diabetic subjects with good glycemic control have lower levels of vaspin than those with poor glycemic control. Thus, the use of serum vaspin level as a marker, evaluating patients for diabetic complications seems appropriate.
Vaspin has insulin-sensitizing effects, as well as additional beneficial effects on metabolic diseases. However, little is known about the direct effects of vaspin on vascular complications mediated by diabetes.
Vaspin have been shown to inhibit hyperglycemia-induced vascular smooth muscle cells (VSMCs) proliferation.
Atherosclerosis has a forefront role in the pathogenesis of stroke. Inflammation has an important place in the formation of atherogenesis and atherosclerosis. Vaspin associated with obesity and diabetes and also has a proinflammatory characteristic.
Vaspin protected endothelial cells from proinflammatory cytokines induced inflammation by inhibition of nuclear factor-kappa B (NF-κB) and its downstream molecules by inhibited tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1), mediated activation of NF-κB and its downstream molecules in a concentration-dependent manner.
In this study, we aimed to evaluate serum vaspin levels in relation to glycemic status and the presence of macro vascular complications in groups of type 2 diabetic patients.
Our study was conducted on sixty patients diagnosed as Type 2 diabetes mellitus were classified into three groups and the fourth group formed of twenty normal persons: group I formed of 20 diabetic patients with coronary artery disease , group II formed of 20 diabetic patients with recent cerebro vascular stroke , group III formed of 2o diabetic patients with diabetic patients without complication and group IV formed of 20 normal volunteer persons .
All subjects recruited in the study were subjected to history taking and full clinical assessment in addition to core laboratory parameters that included FBS, PPBS and HbA1c%, lipid profile, microalbuminuria and serum Vaspin. Also radiological assessment included echocardiography and Carotid duplex to measure intimal thickness, Computerized Tomography brain (CT brain) for patients with cerebrovascular stroke.
The results were statistically analyzed and we observed the following:
Our results showed an insignificant difference in serum vaspin level between diabetic patients with IHD or CVS (P>0.05), yet the mean of vaspin in IHD and C.V.S. was lower than in healthy group.
In our study, the serum vaspin level was found to be significantly positively correlated with diabetes duration where the mean diabetes duration of the subjects involved in this study was less than 10 years (P<0.01).
Our results showed that there was no difference in serum vaspin level between both sexes, and also showed that there is a positive correlation between age and vaspin concentration (P<0.01).
In the current study serum vaspin level was found to be significantly positive correlated with FBS, 2hpp & HbA1c in all studied groups (P<0.01). In addition, our study recorded positive correlation between serum vaspin level & serum cholesterol, TG, LDL & HDL in all studied groups (P<0.01).
In our study intimal medial internal carotid thickness & percent of stenosis on the Rt. side was found to be significantly higher in diabetic cases with IHD compared to diabetic patients without complications or healthy control subjects (P<0.01), however, this difference did not reach a statistical significance on the left internal carotid artery (P>0.05), but the percent of internal carotid stenosis on either sides was significantly higher in diabetic cases with IHD compared to diabetic cases without complications & healthy control subjects , also there was high significant correlation between serum vaspin & Rt intimal medial internal carotid thickness & percent of stenosis on both Rt and Lt sides (P<0.01) but there was no significant correlation between serum vaspin & the left internal carotid artery in diabetic patients with IHD (P>0.05).
In the present work, Rt internal carotid thickness was found to be significantly higher in diabetic cases with C.V.S compared to either diabetic cases without complications or healthy control group (P<0.01), however, this difference did not reach a statistical significance on the left internal carotid artery intimal medial internal carotid thickness (P>0.05), but the percent of internal carotid stenosis on either sides was significantly higher in diabetic cases with C.V.S compared to diabetic cases with IHD, also there was high significant positive correlation between serum vaspin and intimal medial internal carotid thickness on both Rt and Lt sides and also in percent of stenosis on both Rt and Lt sides in diabetic patients with C.V.S compared to either diabetic cases without complications or healthy control group (P<0.01).
Furthermore, our study reported a significant positive correlation between the serum vaspin level and Rt internal carotid intimal thickness and both Rt and Lt sides percent of internal carotid stenosis in patients with T2DM (P<0.01).