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Article
Role of serum IL-18 in type 2 diabetic patients with and without microalbuminuria

Authors: Ali Naser Mohammed Ali AL-Alglani --- AbduladheemYaseen Abbood --- Hazim Abdul Razak Abdul Wahab --- Abbas Mahdi Rahma
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 58-63
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Microalbuminuria is a well-known indicator of poor renal outcomes in patients with type 2 diabetes that leads to diabetic nephropathy (DN), but there are many proinflammatary markers that are elevated during injury to the nephrons which lead to chronic kidney disease, one of those is interleukin - 18 (IL-18). Objective: To confirm the role of serum IL-18 as a novel predictor before DN onset. Patients and Methods: The microalbuminuria levels were measured by immunoturbidimetric method, serum IL-18 levels were measured by ELIZA sandwich method, both serum and urine creatinine levels were measured by colorimetric method and hemoglobin A1c (HbA1c) levels were measured by ion exchange - high performance liquid chromatography (HPLC) in 90 individuals, 20 individuals apparently healthy (group I), 40 diabetic patients without microalbuminuria (urinary albumin to creatinine ratio (UACR) ˂ 30 mg/g) (group II) and 30 diabetic with microalbuminuria (UACR 30 -300) (group III).Results: The mean of serum IL-18 in group I, II and III was 189.30 pg/ml ± 3.269 S.E., 220.83 pg/ml ± 0.900 S.E. and 246.67 pg/ml ± 22.341 S.E. respectively. The difference between group I and II, group I and III, and group II and III was significant (P=0.000 for all). The mean of UACR in group I, II and III was 4.25 mg/g ± 2.359 S.E., 4.20 mg/g ± 1.518 S.E. and 34.17 mg/g ± 0.629 S.E. respectively. The difference between group I and II was not significant (P=1. 000) but between group I and III, and group II and III were significant (P=0. 000 for both). The mean of serum creatinine in group I, II and III was 0.885 mg/dl ± 0.0302 S.E., 0.883 mg/dl ± 0.0240 S.E. and 0.933 mg/dl ± 0.0237 S.E. respectively. The difference between group I and II, group I and III, and group II and III was not significant (P=0.998, 0.331 and 0.145 respectively). The mean of hemoglobin A1c (HbA1c) in group I, II and III was 5.9 % ± 0.0211 S.E., 7.7 % ± 0.0445 S.E. and 8.135 % ± 0.0519 S.E. respectively. The difference between group I and II, group I and III, and group II and III was significant (P=0.000 for all). The correlation between urinary albumin to creatinine ratio (UACR) and IL-18 in group III was significant (r=0.983 with P=0.000). The correlation between hemoglobin A1c and IL-18 was significant (r=0.641 with P=0.000) in group II. The correlation between serum creatinine and IL-18 in group III was not significant (r=0.041 with P=0.830). Conclusion: while the increased IL-18 levels were positively correlated with both HbA1c and UACR that leads to the progression of the diabetic nephropathy and it can be one of the cytokines which opens the possibility of its application in clinical treatment in the future.


Article
Elevated ceruloplasmin and leucocyte count in Type 2 diabetic nephropathy

Authors: Huda Mundher Mahdi --- Khaleed J. Khaleel --- Waleed H.Yousif
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 1 Pages: 82-90
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background : Type 2 diabetes mellitus is chronic disorder that requires proper medical careand education of patients to reduce long term complication like nephropathy .Patients and methods: Forty-five Type 2 diabetic nephropathy patients in early stage wererecruited for this study. Twenty-nine control subjects matched for age were also included.Results : this study demonstrated a significant increase in glycosylated hemoglobin ,randomblood glucose , blood urea , creatinine and total White blood cell count while a significantdecrease in , estimated glomerular filtration rate in Type 2 diabetic nephropathy patientscompared with healthy control . Urine markers including microalbumin and ceruloplasminshowed a significant increase in level in Type 2 diabetic nephropathy patients when comparedwith the healthy control.Conclusion: leucocyte count can be considered as indicator for an inflammatory marker and aceruloplasmin a good urinary marker.


Article
Relationship between microalbuminuria and glycosylated hemoglobin, and some biomarkers of oxidative stress in type 2 diabetes mellitus

Authors: Hawazin Yousuf Khalaf --- Abdulkareem H. Issa --- Abbas M. Rahmah
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2015 Volume: 28 Issue: 2 Pages: 85-93
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Diabetic nephropathy is a common chronic complication in type 2 diabetes mellitus (T2DM) at the time of diagnosis or later on and to progress with longer duration of the disease. Microalbuminuria (MIC) heralds diabetic nephropathy and precedes proteinuria and is an important risk factor for cardiovascular disease (CVD).Once proteinuria develops after microalbuminuria, progression to end-stage kidney disease occurs rapidly over ~5 years.Objective: To identify the relative importance of glycemic control status and some oxidative stress markers in the discrimination between patients with and without MIC so that the more important ones may be a priority targets in the prevention or treatment of diabetic nephropathy.Subjects and methods: One hundred female T2DM patients and 50 apparently healthy aged-matched women as a control group were enrolled in the study. Diabetic patients comprised two groups; group A: DM patients without MIC; group B: DM with MIC. For each study subject, clinical characteristics were recorded and the following parameters were measured: Urinary Albumin: Creatinine ratio (A:C ratio), and serum levels of fasting glucose , HbA1C, uric acid, thiobarbituric acid-reactive substances (TBARS), and α-tocopherol.Results: Group B patients were found to have a significantly higher mean value of BMI, blood pressure, and longer duration of disease. The mean ratio of HbA1C of group B was significantly higher than in group A (8.7 ± 1.4% vs. 7.1 ± 1%, P < 0.001). On comparison of oxidative stress markers then group B had higher serum TBARS (8±1 vs. 5.9±1 µmol/L, P<0.001), and uric acid (5.8±1vs. 4.9±1.1 mg/dl, P<0.001) than in group A but the two groups showed no significant difference in α-tocopherol. The results revealed that there is a high significant positive correlation between serum TBARS levels and uric acid levels in group B (r = 0.565, p <0.001), while it showed a statistically significant negative correlation between TBARS levels and α-tocopherol levels (r = - 0.837, p<0.001).Receiver operator characteristic (ROC) curve was used to discriminate between group B and A. The area under the curve was highest for serum TBARS (ROC area =0.909) followed by HbA1C (0.814) and their diagnostic accuracy were 85% and 77% respectively.Conclusion: Poor glycemic control and oxidative stress are interrelated states that characterize T2DM patients. Among study analytes, serum levels of TBARS and HbA1c have the highest relative importance in discrimination between patients with and without MIC so that may be, in sequence, a priority targets in the prevention and treatment of diabetic nephropathy.


Article
The protective role of alcoholic extract of (Anethum graveolens) seeds on renal function in alloxan induced diabetic rabbits
الدور الوقائي للمستخلص الكحولي لبذور الشبت في وظائف الكلى في الأرانب المصابة بداء السكر التجريبي المستحدث بالالوكسان

Authors: Luma W. Khalil لمى وليد خليل --- Weam A. Shakir وئام عدنان شاكر
Journal: The Iraqi Journal of Veterinary Medicine المجلة الطبية البيطرية العراقية ISSN: 16095693 Year: 2015 Volume: 39 Issue: 2 Pages: 1-6
Publisher: Baghdad University جامعة بغداد

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Abstract

This study was designed to investigate the effect of dill (Anethum graveolens) seeds in mitigating the complications of induced diabetes mellitus such as nephropathy of adult female rabbits. Thirty adult female rabbits were randomly assigned to 5 equal groups and treated daily for 45 days as follows: Control group (C) drenched tap water, control group intubated orally with 700 mg/kg B.W ethanolic extract of dill (T1), diabetic group drenched tap water (T2), diabetic group intubated orally700 mg/kg B.W of dill (T3) and diabetic group treated with insulin injection 3 I.U S/C (T4). Blood samples were collected by heart puncture at 0 and 45 days of experiment to assess renal efficiency: Serum creatinine, serum urea, and serum glutathione (GSH). The results indicated that diabetes mellitus without treatment group (T2) caused renal damage manifested by significant (P<0.05) increase in creatinine, urea and significant (P<0.05) decrease in serum glutathione (GSH) concentration. Oral intubation of alcoholic extract of dill seeds in diabetic treated group (T3) improved renal function through significant (P<0.05) decrease in serum urea, creatinine, and significant (P<0.05) increase in serum glutathione concentration (GSH). It was concluded that alcoholic extract of dill seeds was effective in reducing the complications of diabetes mellitus such as nephropathy.

أجريت هذه الدراسة لمعرفة تأثير نبات الشبت في التخفيف من الإصابه بداء السكر التجريبي المستحدث بالالوكسان والتي منضمنها الاعتلال الكلوي في إناث الأرانب البالغة . استعملت 03 انثى بالغة من الأرانب المحلية، ق سمت الى 5 مجاميع متساويةعشوائي ا كالآتي: مجموعه سليمة للسيطرة ) C (، مجموعة سليمة ومعالجة بالشبت ) T1 (، مجموعة مصابة بداء السكر المستحدثبالالوكسان ) T2 (، مجموعة مصابة بداء السكر ومعالجة بالشبت ) T3 (، مجموعة مصابة بداء السكر ومعالجة بالانسولين .(T4) جرعت حيوانات المجموعتان ) T1 ( و ) T3 033( ، ) ملغم / كغم( بالمستخلص الكحولي لبذور الشبت يومي ا ، في حين حقنتالمجموعة المصابة بالسكري والمعالجة بالانسولين ) T4 ( ب 0 وحدات من الانسولين تحت الجلد يومي ا طيلة مدّة التجربة. وفي مدّةالتجربة البالغة 55 يوم ا جمعت عينات الدم في المدد صفر، 55 يوم من التجربه، وسحب الدم بطريقه الوخز القلبي لغرض دراسةمعايير الكفاءة الكلوية: قياس تركيز الكرياتنين واليوريا والكلوتاثايون في مصل الدم. أظهرت نتائج التجربة أنّ الإصابة بداء السكروبدون العلاج في المجموعة ) T2 (، أدت إلى حصول تلف كلوي وخلل وظيفي تمثل بحدوث انخفاض معنوي (P<0.05) فيتركيز الكلوتاثيون وارتفاع معنوي ) (P<0.05 في مستوى الكرياتنين واليوريا. كما أوضحت النتائج أنّ التجريع الفمويبالمستخلص الكحولي لبذور الشبت في المجموعه ) T3 ( ادى إلى حصول تحسن في وظيفه الكليتين تمثل بانخفاضمعنوي (P<0.05) في اليوريا والكرياتنين كذلك حصول ارتفاع معنوي (P<0.05) في تركيز الكلوتاثيون . نستنتج من هذهالدراسة أن المستخلص الكحولي لبذور الشبت له تاثير فعال في الحد من مضاعفات الإصابة بداء السكر كالاعتلال الكلوي


Article
Estimation of Urinary Vitamin D Binding Protein as a Biomarker in Type 2 Diabetic Nephropathy and its correlation with estimated Glomerular Filtration Rate
تقدير البروتين المرتبط بفيتامين دي البولي كعلامة حيوية فى الاعتلال الكلوي النوع الثاني و علاقتة مع نسبة الأرتشاح الكلوي المقدرة

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Abstract

Background: Diabetic nephropathy is one of the most common complications, which may lead to chronic kidney disease in diabetic patients. Objective:The studyobjectiveis to assess the role of urinary vitamin D binding protein as biomarker before onset of nephropathy in type 2 diabetes. Patients and Methods:The urinary vitamin D binding protein levels were measured by ELIZA , estimated glomerular filtration rate levels were measured by the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation. Ninety individuals were involved in this study which comprises 20 individuals apparently healthy (group I), 40 diabetic patients with normal eGFR (≥ 90 mil/min/1.73m2) and 30 diabetic patients with abnormal value of eGFR (˂ 90 mil/min/1.73m2) (group III). Results:The mean urinary vitamin D binding protein in all groups showed a gradual increase with a significance P values. A negative correlation was obtained between vitamin D binding proteinand estimated glomerular filtration rate in group I with non significant P-value and group IIIwith significant P-value. Conclusion:Since the increased vitamin D binding protein levels were negatively correlated with decreased estimated glomerular filtration rate levels, so vitamin D binding protein level can be considered as a novel predictor for monitoring type 2 diabetes before onset of diabetic nephropathy.

الخلفية: الأعتلال الكلوي السكري يعتبر من المضاعفات الأكثر شيوعاً التي تقود الى المرض الكلوي المزمن في مرضى السكري.المرضى و الفحوصات: مستويات البروتين المرتبط بفيتامين دي البولي كانت مُقاسة بطريقة الأليزا, نسبة الأرتشاح الكلوي المقدرةكانت مُقاسة بمعادلة علم الوبائية-مرض الكلية المزمن. تسعون فرداً كان مشمول في هذة الدراسة التي تتكون من 20 شخص صحي سريرياً (المجموعة الأولى), 40 مريض سكري بنسبة ارتشاحكلوي مقدرة ضمن الحد الطبيعي (≤90مل/دقيقة/1.73م2) (المجموعة الثانية), و أخيراً 30 مريض سكري بنسبة ارتشاح كلوي مقدرة دون الحد الطبيعي (˃ 90 مل/دقيقة/1.73م2) (المجموعة الثالثة)النتيجة:الدراسة أظهرت أن معدل مستويات البروتين المرتبط بفيتامين دي البولي في المجاميع الثلاثة تُظهر زيادة تدريجية مع فُروقات أحصائية مهمة. كما أن الدراسة أظهرت علاقة سلبية بين مستويات البروتين المرتبط بفيتامين دي البولي و مستويات نسبة الأرتشاح الكلوي المقدرة في كل من المجموعة الأولى بعلاقة غير مهمة أحصائياً و المجموعة الثالثةبعلاقة مهمة أحصائياً.الأستنتاج:لما مستويات البروتين المرتبط بفيتامين دي البولي المتزايدة كانت مرتبطة بصورة سلبية مع المستويات المنخفضة لنسبة الأرتشاح الكلوي المقدرة, أذن مستوى البروتين المرتبط بفيتامين دي البولي يمكن ان يعتبر كدليل رائد لمراقبة مرضى السكري قبل حدوث الأعتلال الكلوي السكري.

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