Soluble Lectin-Like Oxidized Low Density Lipoprotein Receptor-1 as a Biochemical Marker for Diabetic Vasculopathy in Type 1 Diabetes Mellitus

Dina Fathy Mohammady Haider


Abstract


SUMMARY D iabetes mellitus is a chronic metabolic disorder characterized by high plasma glucose caused by an impairment of insulin production, insulin action or both. Type 1 diabetes mellitus is potentially associated with serious microvascular and macrovascular complications. Diabetic nephropathy and cardiovascular disease are major causes of morbidity and mortality in patients with diabetes mellitus. Multiple markers of renal dysfunction, either tubular or glomerular, can appear before the detection of microalbuminuria, suggesting that microalbuminuria occurs once significant kidney damage has already occurred. Soluble lectin like oxidized LDL (sLOX-1) has been identified as a key factor in the pathogenesis of diseases with significant microvascular complications. Increasing evidence shows that sLOX-1 levels in plasma, serum and urine have promising biomarker applicability in these disorders. In view of these data, this study aimed to determine soluble lectin like oxidized LDL (sLOX-1) levels in children and adolescents with type 1 diabetes mellitus as a potential marker for diabetic vascular complications including diabetic nephropathy and assess its relation to the clinicopathological characteristics of patients, glycemic control and carotid intima media thickness. This cross sectional study was carried out on 60 children and adolescents with type 1 diabetes mellitus (38 males and 22 females with a male-to-female ratio 1.7:1) attending the Pediatric Diabetes Clinic, Pediatric Hospital, Ain Shams University. Another group of 30 age- and sex-matched healthy individuals; 17 males and 13 females (ratio, 1.3:1) were enrolled as controls. The mean age of patients was 12.5 ± 3.1 years (range, 6-17 years) while that of controls was 11.3 ± 3.0 years (range, 6-17 years). All the included patients were subjected to: (i) Detailed medical history with special emphasis on age at onset of diabetes, disease duration, insulin therapy and chronic diabetic complications (retinopathy, neuropathy, nephropathy, or cardiovascular ischemic events); (ii) Thorough clinical examination laying stress on anthropometric measures, blood pressure, fundus examination and neurological assessment; (iii) Laboratory investigations including measurement of mean fasting blood glucose (FBG), routine liver and Kidney function tests, fasting lipid profile, mean HbA1c%, urinary albumin excretion and high sensitivity C-reactive protein (hs-CRP). Determination of serum Slox-1 levels by enzyme linked immunosorbent assay (ELISA). In the current work, it was observed that 26 patients out of 60 had nephropathy, 9 patients had peripheral neuropathy and none of them had retinopathy. Thus, the most common microvascular complication encountered in the studied patients was diabetic nephropathy being in 43.3% of patients followed by peripheral neuropathy 15%. Upon comparison between patients and control subjects, FBG, HbA1c, serum creatinine, triglycerides, total cholesterol, UACR and hs- CRP were significantly higher while HDL cholesterol was lower in diabetic patients than healthy controls. Slox-1 levels were significantly elevated in all diabetic patients compared with controls.


Other data

Other Titles مستقبل البروتين الدهني منخفض الكثافة-1 (مشابه الليكْتين) المؤكسد المذاب كمؤشر حيوي على الاعتلال الوعائي السكري في النوع الأول من داء السكري
Issue Date 2016
URI http://research.asu.edu.eg/handle/12345678/54229


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