مقارنة بين النوع الثاني من مرض السكري ومرض السكري المناعي الذاتي المتاخر الظهور للبالغين باستخدام مؤشرات الخلايا اللمفاوية وملف الحركيات الخلوية == Comparison Between Type 2 Diabetes Mellitus And Latent Autoimmune Diabetes of Adults Using Lymphocytes Markers And Cytokines Profile
Author name:
سوسن محمد جبار الحسناوي
Supervisor name:
سلمان عزيز الجبوري
General topic:
Medicine
Specific topic:
Microbiology
Degree:
Doctorate
University:
University of Kufa - Faculty Of Medicine - Department Of Microbiology
Language:
English
University location:
Najaf
First pages:
19T1102 - p.pdf
Abstract:
This study was done to investigate whether Type 2 diabetes and Latent autoimmune diabetes of adult (LADA) patients have similar or different immunological profile.Therefore, measurement of serum levels of adhesion molecules (Serum intracellular cell adhesion molecule(sICAM - 1), Serum vascular cell adhesion molecule (sVCAM - 1) and Serum endothelial Selectin (sESelectin)), chemokines (CCL2, CCL3 and CCL4) and cytokines (IL - 6, IL - 1receptor antagonist and IFN - ?) in these patients was done. In addition to the influence of BMI, gender, age and diabetes duration on these systemic immune mediators were analyzed. Also, the relationships of the in vivo levelsof these mediators with micro - & macro - vascular complications in type 2 diabetes & LADA were studied.Three hundred individual were enrolled in this study and were divided into two subgroups : patients and control groups (280 patients& 20 control). From the 280 patients group who were clinically diagnosed as type 2 D.M., 34 patients were GADA positive and considered as LADA cases. Serum samples were taken from The 34 LADA cases, 36 cases of D.M.2 (selected randomly from the remaining 246 diabetic type 2 patients) & 20 healthy control subjects.The prevalence of LADA among D.M.2 patients was 12.1%. A significant difference in family history, BMI, FBS, HA1C & duration of D.M. was found in D.M.2 cases compared to LADA cases. The mean sVCAM - 1level of control group was significantly lower than D.M.2 and LADA group, P<0.05. The sE - Selectin level was higher in LADA group than control and D.M. type 2 group & significantly different when compared to control group (P<0.05). The sVCAM - 1 level had a significant positive correlation (R=0.25, P=0.017) with BMI in all groups. LADA group had significantly higher values of CCL2 while D.M. type 2 had the least values (P=0.002). The mean IL - 6 of D.M. type 2 group was (11.6±3.1), for LADA group it was (12.4±1.7) and for the controls it was 0.95 ± 0.14. There was a statically significant difference between D.M.2 vs. controls, and LADA vs. controls (P<0.05), regarding the mean IFN - ?, it was significantly higher in LADA group than D.M.2 group (87.5 ± 20.3) vs. (40.3 ± 4.5) respectively, (P=0.032).The mean IL - 1receptor antagonist was significantly higher in D.M. type 2 and LADA cases than controls (P<0.05). A significant positivecorrelation between IL - 6 and sICAM - 1, (R= 0.27, P= 0.013) & a highly significant positive correlation between IL - 6 and IL - 1RA, (R= 0.35, P=0.001) were found. IL - 6 & IL - 1RA serum levels in D.M. type 2 patientswere significantly associated with the complications where p - value?0.05. For conclusions, LADA is clinically underestimated among D.M. type 2 patients and increases with increasing age. Also, Levels of CCL2 and IFN - ? are associated with autoimmunity, Levels of adhesion molecules & chemokines are associated with complications of diabetes.
