Author name:
سعدون عباس عيدان السالمي
Supervisor name:
عدنان جاسم محمد الفرطوسي | ناظم عبد النبي عواد
Key words:
- Diabetic nephropathy
- Trace elements
- Oxidative stress
- Obesity
- Insulin resistance
Abstract:
Diabetic nephropathy (DN) is a common and severe microvascular complication of type 2 diabetes mellitus (T2DM) that can result in end-stage renal disease (ESRD). Hence, the aim of the present study is to study the impact of insulin resistance (IR) on specific blood and urinary biomarkers for early predicting of DN in men and women of T2DM obese-patients of the population of Basrah province (southern of Iraq). In this study, 186 men and women volunteers were participated. Sixty-three of patients' with T2DM [31 patients who suffering from DN (15 men and 16 women) and 32 patients without DN (15 men and 17 women)] and 33 healthy controls (16 men and 17 women) were followed up for 8 months, till end the study while 90 of volunteers (50 patients and 40 healthy controls) were excluded from the study because enable to follow up study. The three groups were matched for some blood (glucose, insulin, urea, creatinine, BMI, GFR, CrCl, IR, Hcy, FA, Cys C, LC, OPG, SA, Se, Zn, Mg) and urine (Alb, NGAL, 8-OHdG and FN) biomarkers. Compared with normal controls, the results indicated that T2DM patients with and without DN had a significantly (p<0.01) increased levels of glucose, insulin, IR, Hcy, FA, SA, NGAL and 8-OHdG. Furthermore, patients with T2DM with DN had a significant increase (p<0.01) and patients with T2DM without DN had a significant increase (p<0.05) in the levels of serum urea, creatinine, Cys C, OPG, Alb and FN, compared to healthy control. On the other hand, our data reported that GFR, CrCl as well as LC were decreased significantly in T2DM patients (p<0.01 in patients with DN and p<0.05 in patients without DN), while levels of Se, Zn and Mg were significantly (p<0.01) lower in T2DM patients with and without DN as compared to control group. Moreover, the results obtained indicated that there was a non-significant change (p>0.05) in BMI level in T2DM patients with and without DN as compared to control group. We conclude that insulin resistance is strongly associated with obesity and had an important role in the pathogenesis and increased complicating of many human diseases such as diabetes which can be used as a biomarker of renal dysfunction in DN thus decreasing the mortality and morbidity. Hence, taking into consideration the combination of obesity, IR and T2DM may demonstrated excellent indicator for early-stage DN in patients with T2DM.
