CLASS II MAJOR HISTOCOMPATIBlLITY COMPLEX IN EGYPTIAN TYPE 1 DIABETIC PATIENTS AND ITS PREDICTIVE VALUE FOR LONG TERM COMPLICATIONS

Abstract

The ai m of the present study was to d etect the poten tial association between HLA cl ass U DR a nd DQ genotypes and the susceptibility or resistance to type 1 diabetes and its long-term complications among Egyptian population.

The study was conducted on 1 30 Egyptian su bjects, 60 patients with type l diabetes and 70 healthy control s.

Dia betic patients (n = 60) were recruited fi-om Ai n Shams University Hospital s. Forty of them had long-tem1 diabet ic complications ( neph ropathy, retinopathy and peripheral neuropathy). Healthy con t rols were selected from kidney transplant donors in Immunogenetics & Transplantation Unit, Ain Shams Uni versi ty Specialized Hospitals.

For all patients en rolled into the stud y the foll owing was done: fu ll history and physical examina tion, resting ECG, fu nd us exa minati on, glycemic indices includ i ng fasting blood sugar and glycohemoglobin (HbA1 c), 24 hours u rinary protein excret ion, and H LA class II typi ng (DR & DQ) by mi crocytotoxci cit y test.

The current st udy showed that the freq uency of 1:-ll__ A DR4 was significa ntly higher in Egyptia n t ype Idiabet ic pa tients (5 1 .6%) compared to healthy con trol s (30%)(P < 0.05, RR = 2.49). DR3 was d etected in 48.33% of ty pe 1 d ia betic pa tients versus 35% among healthy cont rols but with no stati sticall y signi fica nt d i fference ( P > 0.05, RR = 1 .68).

It was al so found that DR3/DR4 heterozygosity was significantl y higher in Egypti a n type I diabeti cs (23.3%) compared to healthy controls (4.3%)(P < 0.01 ).

ln addition, Egyptia n type 1 diabetic patients with d isease onset after age 1 6 showed a numericaJiy hjgher percentage of non-DR3/no n­ DR4 genotype (78%) when compared with t hose with disease onset prior to age 1 6 (69.5%)(P > 0.05). Whi le DR3/DR4 genot ype frequency was nu merically higher in diabetic patients wi t h onset before