اسم المؤلف:
محمد علي سلمان علیوي الكعبي
اسم المشرف:
كریم ثامر مشكور الكعبي | جعفر كاظم الموسوي
المستخلص:
It has been proposed that the balance of Th1 and Th2 cells is critical in the development of Type 1 diabetes and much of the genetic susceptibility to IDDM maps to the MHC class II region, thus one approach to investigate the immunopathogenesis of diabetes is to study first degree relatives of affected individuals.A case - control study was performed on 120 persons, they divided into three group which are diabetic, siblings and control (40 persons in each group), who attended to Al Zahraa Teaching Hospital /Diabetic Center in Al Kut between the period from April; 2012 till April; 2013. OGTT performed on both diabetic siblings and control, results have showed that the means of OGTT is highly Significant (P value = 0.000) in both siblings and control groups, whereas there were no Significant differences in the Means of differences of OGTT in both tested groups (Siblings and Control), P value = 0.288, although the mean of differences of OGTT is higher in siblings group (25.3250) than that in control group (22.0750). Cytokines levels (IFN - gamma, IL - 2, IL - 4 and IL - 10) were determined among the study groups (type 1 diabetes, siblings and control) by ELISA method, results showed that the means of IFN - gamma and IL - 2 levels were highly Significant (P value = 0.012, 0.037 respectively) in type 1 diabetic group , in comparison to their corresponds among both siblings and control groups, whereas the mean of IL - 4 levels was non - significant (P value = 0.738) among the study groups (type 1 diabetes, siblings and control), in spite it was higher in control group (0.81936) than that in both type 1 diabetic patients and their sibling (0.74387, 0.77593 respectively).While in case of IL - 10 results showed that the mean was highly significant among control group (P value = 0.030) in comparison to its corresponds among both type 1 diabetic patient and their siblings. Distribution of HLA - DRB1 loci among the study groups (type 1 diabetic patients, siblings and control group) were performed using MR.SPOT ROBOTING system, results showed that the frequencies of HLA - DRB1*3,*4 {25 (69.4%)} among diabetic group were Significant in differences (P value = 0.002), in comparison to the corresponding frequencies among control group {11 (30.6%)}, in comparison to the frequencies of other HLA - DRB1 loci in both diabetic group and control group { 15 (34.1%), 29 (65.9%)} respectively.Meanwhile results showed that there were no Significant differences (P value = 0.116), in the frequencies of HLA - DRB1*3,*4 {25 (58.1%)} among diabetic group in comparison to the frequencies of HLA - DRB1*3,*4 {18 (41.9%)} among siblings group, in compare to the frequencies of other HLA - DRB1 loci among diabetic group and sibling group {15 (40.5%), 22 (59.5%)} respectively, also results have showed that there were no Significant (P value = 0.104), in the frequencies of HLA - DRB1*3,*4 {18 (62.1%)} among sibling group in compare to the frequencies of HLA - DRB1*3,*4 {11 (37.9%)} among control group, in compare to the frequencies of other HLA - DRB1 loci among sibling group and control group {22 (43.1%), 29 (56.9%)} respectively. In another part of this study we estimate the relation between means of HbA1c and their corresponding HLADRB1 Loci among the study groups, result have showed that there was a significant relation (P value = 0.010) between the Means of HbA1c and their corresponding HLA - DRB1*03 Locus among the study groups. In conclusion the higher Mean of differences of OGTT among Siblings group might reflect the potential of them to develop diabetes, also T1D is Th1 mediated disorder, while Th2 cytokines profile might play a protective role against the development of T1D,in addition the genetic predisposition of diabetic Siblings for development of diabetes since, both diabetic group and sibling group showing the highest frequencies of HLA - DRB1 *3,*4, in compare to Control group and finally HbA1c might have an inheriting pattern. In conclusion diabetic siblings more prone for development of diabetes in future.
