الفهرس 
Type 2 diabetes mellitusOnly 14 pages are availabe for public view
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Abstract
The majority of diabetes-related mortalities are due to macrovascular complications. Atherosclerosis accounts for virtually 80% of all deaths among diabetic patients. The early detection of atherosclerotic complications is important in reducing mortality and morbidity from cardiovascular events . Prolonged exposure to hyperglycemia is now recognized a major factor in the pathogenesis of atherosclerosis in diabetes. Hyperglycemia induces a large number of alterations at the cellular level of vascular tissue that potentially accelerate the atherosclerotic process. OPG is a soluble glycoprotein, member of the TNF receptor superfamily, involved not only to bone formation but also to the development of vascular complications. Whether OPG is beneficial or injurious to the vasculature, it simply represents a biochemical marker of vascular damage.OPG was identified as a cytokine that binds to two ligands, RANKL (receptor activator of nuclear factor kB ligand), a critical cytokine for osteoclast differentiation, and TRAIL (TNF-related apoptosis-inducing ligand), involved in immune surveillance. Thus, by acting as a decoy receptor for RANKL and TRAIL, OPG inhibits the nuclear factor-kB’s regulatory effects on inflammation, skeletal, and vascular systems. OPG mRNA has been detected in a variety of human tissues, including the lung, heart, and kidney. The present study aimed to assess the level of osteoprotegerin in patients with type 2 DM as an early marker for atherosclerosis especially in patients with microalbuminuria and its correlation with other risk factors of cardiovascular disease in diabetic patients. The study included 60 patients suffering from T2DM, (35 males and 25 females) their ages ranged from 45 - 64 years. In addition, 20 apparently healthy, age and gender matched subjects were involved as a control group (10 males, 10 female). The ages of the control group ranged between 42 – 60 years. The patients were divided according to the presence or absence of microalbuminuria into:- 1) Group I: It consisted of 20 diabetic patients without microalbuminuria (normoalbumiuric). They were 13 males and 7 females with ages ranged between 45- 61 years. 2) Group II: It consisted of 40 diabetic patients with microalbuminuria. They were 21 males and 19 females with ages ranged between 45- 64 years. Candidates of the present study were subjected to clinical evaluation and laboratory investigations in the form of of FBG, HbA1c, T.cholesterol, triglycerides, LDL-c,HDL-c,creatinine,urea, microalbumin in urine, and serum level of OPG by ELISA. Statistical comparison was done between different studied patients groups and the control group. The results of the present work showed that:-
*No statistically significant differences among the studied groups regarding age, gender & smoking As regards the demographic criteria:
-There was statistically significant difference between the studied groups as regard BMI, SBP and DBP. As regards the biochemical markers:
-The mean differences between the whole studied groups of biochemical markers (FBG, HbA1c and urea,) were highly significant (P<0.001). However, no significant difference detected between all studied groups regarding creatinine (P>0.05). As regards the lipid profile :
-The mean differences of lipid profile were highly significant between the all studied groups (P<0.001 ). As regards CIT:-
-The mean differences of CIT were highly significant between the all studied groups (P<0.001 ). As regards the OPG level :
-The mean OPG levels were higher in diabetics compared to controls.
-There were a highly significant difference between the studied groups regarding OPG(P<0.001). As regards correlation between OPG level and other studied parameters:-
-There were significant positive correlations between OPG and each of urea, creatinine, TC, triglycerides, LDL-c and CIT, on the other hand,there was significant negative correlation between OPG and HDL-c. While there were no significant correlations between OPG and each of age , BMI, HbA1c, SBP & DBP. Receiver operating characteristic (ROC) graph analysis of OPG with CIT revealed that the cutoff point was 6.25 pmol/l, the sensitivity was 90%, the specificity was 87%, Positive predictive value was 92% and Negative predictive value was 84%.