The Correlation between Serum Level of ADAMTS-13 and Caroteid Intima- Media Thickness and the Prevalence of Micro and Macro Vascular Complications in Patients with Type -1 DM

Abstract

Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by excess inflammation. The incidence of T1DM diabetes is increasing worldwide, and this increase cannot be accounted for by known genetic factors. The VWF multimeric size is modulated by ADAMTS13. ADAMTS13 is produced predominantly by hepatic stellate cells. A deficiency of ADAMTS13 is seen in patients with thrombotic thrombocytopenic purpura (TTP) and it has been suggested that platelet activation and hypercoagulability also contribute to the pathogenesis of diabetic microvascular complications. Individuals with diabetes have a 2- to 10-fold increased risk for the development of atherosclerotic diseases compared with the normal population. Thus, increased morbidity and mortality due to coronary, cerebrovascular, and peripheral arterial disease have been observed. High-resolution ultrasound is a reliable, noninvasive method for detecting early structural and functional atherosclerotic changes in the arterial wall. Increased carotid intimamedia thickness (IMT), a structural marker of early atherosclerosis, relates to the severity and extent of coronary artery disease and predicts the likelihood of cardio- vascular events in population groups. Aim of the work The aim of the current study is to investigate the correlation between serum level of ADAMTS-13 and carotid intima-media thickness with the prevalence of micro- and macro-vascular complications in patients with type-1 diabetes mellitus.