الفهرس | Only 14 pages are availabe for public view |
Abstract Globally, an estimated 422 million adults are living with DM according to WHO in 2016. This number is expected to double by 2030. In DM, protein, lipid and nucleic acid alteration is involved, as well as cross-linking and formation of nondegradable aggregates, such as AGEs. Formation of endogenous or uptake of dietary AGEs can lead to further protein modifications and initiation of several inflammatory signaling pathways. AGEs are proved to affect nearly every type of cell and molecule in the body, and are thought to be a significant factor in aging and some age-related chronic diseases. Their accumulation has been implicated in Alzheimer’s disease, cardiovascular diseases, and strokes. In the context of cardiovascular disease, AGEs can induce cross linking of collagen, leading to vascular stiffening and entrapment, as well as glycation and oxidation of LDL in the artery walls. Oxidized LDL is the major factor in the development of atherosclerosis. They also induce systolic and diastolic dysfunction by direct action on myocardium. Evidence also suggests that AGEs contribute to cognitive impairment by increasing the formation and deposition of neurofibrillary tangles and amyloid plaques which may exacerbate existing neurodegenerative processes, such as Alzheimer disease. Therefore, DM may impact tremendously on societies in the upcoming decades as world population ages. In Egypt studies addressing effect of AGEs on coronary risk and cognitive and executive functions in elderly are scarce. The aim of the current thesis was to study the relationship between AGEs and Coronary risk factors and Cognitive and Executive Function in Elderly Diabetics. A comparative cross sectional study was conducted on 90 elderly subjects, 60 years or older. Subjects were recruited from Ain Shams University Hospitals, in patient departments and outpatient clinics. The subjects were divided into three groups. group I: (30) healthy subjects without DM and without comorbidities, group II: (30) subjects with DM and without co-morbidities and group III: (30) subjects with DM and with co-morbidities. All participants were subjected to history taking and examination with special emphasis on duration of DM, mode of treatment and complications as well as cardiovascular co-morbidities. FBS, 2 hrs PP, HbA1C, lipid profile and AGEs were measured in all subjects. Coronary risk was calculated for all subjects through online AHA calculator. Finally, cognitive and executive function was tested in all subjects by MMSE, forward and backward digit span, verbal fluency (animal category), judgment and abstraction. The study concluded that MMSE was higher in group I (healthy subjects) than diabetic groups with statistical significance. Coronary risk was higher in diabetic groups than group I subjects. AGEs were lower in group III than other groups. A positive correlation was detected between serum glucose and AGEs in group I and II. Moreover, a significant positive correlation was detected between AGEs and coronary risk in study group II. AGEs and coronary risk were not significantly associated with worse cognitive or executive function. Forward span was negatively correlated with FBS and 2hrs PP in group I and III respectively and MMSE was negatively correlated with 2hrs PP in group II. |