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العلاقة بين مرض السكري المناعي الذاتي الكامن النمط الثاني للبالغين مع الخمج بالملوية البوابية == Association Between Latent Autoimmune Diabetes Of Adults In Type Ii Dm With Helicobacter Pylori Infection
Author name:
سيف علي مكلف
Supervisor name:
عروبة خالد عباس | مدين علي حسين
General topic:
Medicine
Specific topic:
Microbiology - Bacteria
Degree:
Master
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
19T1141 - p.pdf
Abstract:
Latent Autoimmune Diabetes in Adults (LADA) is a form of diabetes which is less recognized and underdiagnosed type of diabetes which appears to have characteristics of both type 1 (autoimmune in nature) and type 2 diabetes (adult age at onset).Helicobacter pylori (H. pylori) infection has a worldwide distribution. The bacteria colonize more than half of the world population and consider the main cause of gastritis, peptic ulceration, gastric adenocarcinoma and gastric lymphoma. The host immune response is unable to clear the infection and may actually contribute to the associated pathogenesis, also the bacterial virulent factors had certain role in the pathogenicity of infection as it was stated by limited studies that the Cytotoxin associated gene A (CagA) protein and Vacuolating cytotoxin gene A (VacA) protein positive strains are possibly associated with severe infections.The present study was designed to find out the percent of LADA patients among group of type II Iraqi diabetic patients and the relation between LADA patients and H. pylori infection.The study was carried out on 350 type II patients attending the National Diabetes Center/ Al - Mustansirrhea University/ Baghdad Al - Yarmouk during the period May to October 2014 were recruited for this study. Diagnostic markers for LADA, namely, C - peptide levels by Radioimmunoassay and GAD autoantibodies by ELISA test were determined and other Various parameters such as, HbA1c levels, Anti - H.pylori IgG, Anti - CagA protein and Anti - VacA protein by ELISA test were evaluated and correlated with type 2 diabetes and 40 control, matched by age and gender were also included.57 patients of 350 of type II have low C - peptide level, from which, 40 patients have Anti - GAD65 positive and 17 patients have Anti - GAD65 negative.The percentage of LADA patients among type II diabetes was 11.4%.The mean serum levels of C - peptide of LADA patients, controls and type II diabetes (0.30 vs. 1.94 and 3.15ng/ml) were significantly lower in LADA patients as compared to controls and type II patients (p?0.05).Also the mean blood concentrations of HbA1c of LADA patients, type II and controls (8.5 vs. 7.5 and 5.2 %) were significantly higher in LADA patients as compared to type II patients and controls (p?0.05).The Higher frequency of anti - H. pylori IgG was in LADA patients when compared with patient's controls and healthy controls (59.6%, 21.3% and 19.1%) and the p - value (?0.05).In conclusion, Cytotoxic associated gene A protein (Cag A) protein is more frequency with H. pylori positive patients 36/47 (76.6%) indicate an important role of this virulence factor in the pathogenesis of H. pylori, so they could be considered as a good biomarker for discern the risk of developing serious gastroduodenal disease in the host, than Vacuolating cytotoxin A Protein (Vac A) which is less frequency than Cag A in H. pylori positive patients 16/47 (34%).
