الفهرس 
Diabetes mellitus (DM)
Environmental factorsOnly 14 pages are availabe for public view
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Abstract
Genetic susceptibility plays an important role in the pathogenesis of diabetic nephropathy. Diabetic nephropathy is the most common cause of end-stage renal disease. It has been suggested that inflammatory mechanisms contribute significantly to the development and progression of DN. These include the infiltration of renal compartments by lymphocytes and monocytes/macrophages as well as local production of cytokines and chemokines in the kidney. These different inflammatory molecules, including proinflammatory cytokines have been proposed as critical factors in the development of microvascular diabetic complications, including nephropathy. It has been suggested that genetic variations in the genes encoding the inflammatory cytokines might confer susceptibility to DN by altering the function and/or expression of these cytokines. Insulin-like growth factor-I (IGF-I) is a peptide that has an important role in the promotion and maintenance of insulin secretion and β-cell mass and in regulation of myocardial structure. The IGF-1 gene is on the long arm of chromosome 12q23–23. IGF-I gene polymorphism are known to play an important role in diabetic nephropathy. Low IGF-I levels have been associated with an increased risk of cardiovascular disease (CVD). In patients with type 2 diabetes, low serum IGF-I levels are common which may play a role in the development of vascular complications of type 2 diabetes. TGF-β1, a multifunctional cytokine, plays an important role in embryonal development and in regulating repair and regeneration following tissue injury. Renal cells are rich source of transforming growth factor beta, and they serve as targets for its actions. We aimed to investigate polymorphisms of IGF-1 gene and level of TGF-β1 in patients with type II DM complicated with diabetic nephropathy. Also, to find a possible relation to serum levels of some biochemical markers in such disease in Egyptians. The present study was carried on 77 adults. They were selected from outpatients and inpatient clinics, Mansoura University Hospitals, Dakahlya, Egypt, where they were diagnosed with Diabetes mellitus. They were chosen from males and females. A control group consists of 25 healthy volunteers. The overall individuals were divided into two main groups: a) Healthy Control group (group 1) This group consists of 25 normal adult healthy volunteers. b) The patient group The patients were divided into two groups as follows: group 2: 26 type 2 diabetic patients with no diabetic nephropathy. group 3: 26 type 2 diabetic patients with diabetic nephropathy. The results showed that The distribution of IGF-1 gene polymorphisms reflect a significant association with DN where the frequency of variant genotype GG in polymorphism rs6214 was found significantly higher in diabetics with nephropathy than other groups (OR= 20.57, 95 % CI: 2.25 – 74, p = 0.001). Moreover, the frequency of variant AA in polymorphism rs10860860 also found to be significantly higher in diabetics with nephropathy (OR=7.37, 95 % CI: 1.87 – 30.07, p = 0.001). There were statistically significant genotype-dependent variations with Chapter 6 - 104 - Summary and Conclusion serum levels of TC, LDL-C, creatinine and uric acid convenient with poorer renal function. There is positive significant correlation between TGF-β1 and (Cholesterol, Triglyceride, LDL-C, Uric acid, Creatinine, HBA1c and FBs), while it showed negative significant correlations with HDL-C.