الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
T
ype 2 diabetes mellitus (T2DM) has reached global epidemic proportions, with more than 382 million people affected according to a 2013 estimate. By 2035, its prevalence is expected to reach 471 million, meaning that 10% of the world’s population will have diabetes.
Patients with diabetes often suffer from metabolic abnormalities, poor glycemic control, oxidative stress, insulin resistance, and low-grade inflammation. These conditions trigger vascular dysfunction, which predisposes them to atherothrombosis.
The coronary risks associated with T2DM are similar to those of nondiabetic patients with previous myocardial infarction (MI).
Diabetes almost doubles the risk of having a stroke. This is because high levels of glucose in blood can damage the blood vessels, making them harder and narrower and more likely to become blocked. If this happens in the cerebral blood vessels it could cause a stroke .
Diabetic subjects have a very high risk of death from stroke. More than one fifth of stroke deaths in the population can be attributed to diabetes, more in women than in men. Diabetes should be taken into account when the stroke risk profile of a population is analyzed .
The cardiovascular risks remain high, even after optimal glycemic and metabolic control has been achieved. Thus, identifying novel risk factors can provide better preventive strategies for individuals at high risk of cardiovascular events.
Platelets have a key role in the development of acute complications of atherosclerosis. The first step in the development of atherosclerosis is the platelets’ adhesion to the endothelium. As larger platelets are metabolically more active, the volume of the platelet is one of the determinants of platelet function.
Mean platelet volume (MPV) is a measure of the average size of platelets in the circulation. Considerable evidence suggests that MPV can be used as a potential biomarker of cardiovascular disease (CVD).
In addition to the studies reporting that increase in the mean platelet volume (MPV) is an early indicator of inflammatory process and increased platelet activation, there are publications claiming that it constitutes a new risk factor for atherosclerosis .
Recent studies reported that increased MPV is associated with the presence of angina pectoris, severity of coronary artery occlusion, and even poor prognosis for acute MI .
Arterial stiffness is a manifestation of structural and functional changes in the vascular wall and a strong predictor of cardiovascular events and mortality. It is also a link between diabetes and increased cardiovascular risks .
The present study was aiming to study the Mean platelet volume (MPV) as a potential risk factor for ischemic heart disease and cerebrovascular stroke in type 2 diabetes.
The study was conducted on 150 subjects there age was from 40 to 60 years and they were divided into 4 groups:
group 1: was include
30 type 2 diabetic overweight or obese patients without previous history of myocardial infarction or cerebrovascular stroke. And were subdivided into 2 subgroups:
a) 15 patients diabetic non hypertensive.
b) 15patients diabetic and hypertensive.
group 2: was include
) 30 type 2 diabetic overweight or obese patients with recent cerebrovascular stroke. And were subdivided into 2 subgroups:
a) 15 patients diabetic non hypertensive.
b) 15 patients diabetic and hypertensive.
B) 30 type 2 diabetic overweight or obese patients with acute myocardial infarcion. And were subdivided into 2 subgroups:
a) 15 patients diabetic non hypertensive.
b) 15 patients diabetic and hypertensive.
group 3:
30 overweight or obese non diabetic patients with acute myocardial infarction or recent cerebrovascular stroke:
a) 15 patients with acute myocardial infarction.
b) 15patients with recent cerebrovascular stroke.
group 4:
30 Healthy control with matching age and sex and were subdivided into 2 subgroups:
a) 15 lean subjects
b) 15 overweight or obese subjects
All subjects in this study were subjected to Full medical history taking.
Thorough clinical examination (including weight, height, BMI, blood pressure).
The following laboratory investigations:
• Fasting blood glucose.
• Two hour post prandial.
• HbA1c.
• Fasting insulin (for HOMA IR)
• Lipid profile (Total cholesterol-LDL-HDL-Triglycerides).
• Mean platelet volume.
• Liver and kidney function test.
The following radiological investigation:
• Carotid ultrasonography for estimation of intima-media thickness.
• Abdominal ultrasonography.