الفهرس 
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Abstract
Diabetic nephropathy is a clinical syndrome characterized by a set of structural and functional kidney abnormalities in patients with diabetes mellitus and is the leading cause of end stage renal failure. allograft inflammatory factor one is a calcium-binding protein which has a relationship with T2DM. The aim of this work was to investigate the alteration of AIF-1 level and its relation to the severity of nephropathy in T2DM patients The study included 35 patients suffering from T2DM without diabetic nephropathy, (20males and 15 females) their ages ranged from 35 – 65 years, and another 35 patients suffering from T2DM with diabetic nephropathy (22males and 13females) their ages ranges from 45-70 years In addition, 18 apparently healthy, age and gender matched, subjects were involved as a control group (10males, 8female). The ages of the control group ranged between 40-65 years. The studied individuals were divided into 3 groups group I: ”Control group”: It consisted of 18 individuals (10 males,8 female) of apparently healthy, age and gender matched, subjects. The ages of control group ranged between 40-65 years. group II: Diabetic patient without nephropathy”: It consisted of 35 diabetic patients with normoalbuminuria. They were 20 males and 15 females with ages ranged between 35 –65years. group III: Diabetic patient with nephropathy”:: It consisted of 35 diabetic patients with microalbuminuria. They were 22 males and 13 females with ages ranged between 45-70years. *The last 2 groups divided according to result of microalbumin in urine All individuals were subjected to detailed history taking, full clinical examinations, anthropometric measurements, laboratory investigations in the from of fasting blood glucose, kidney function tests(blood urea &serum ceratinine), estimated GFR, Glycated Hb (HbA1c), Microalbumin in urine ,serum AIF-1 concentration by ELISA. Statistical comparison was done between different studied patients groups and the control group. The results of the current study showed: The studied groups were well matched as regard ages, gender and smoking. As regards the demographic criteria There was statistically significant difference between diabetics and control group as regard weight, SBP, DBP and MBP. However, no significant difference detected between all studied groups regarding height. As regards the biochemical markers: The mean differences between the whole studied groups of biochemical markers (HbA1c, e GFR and microalbumin) were highly significant (P<0.001). As regards duration and treatment of diabetes mellitus: The mean differences of duration and treatment of diabetes mellitus were highly significant between the all studied groups (P<0.001 ) As regards duration of hypertention There was statistically significant difference between diabetics and control group as regard duration of HTN. As regards the AIF-1level: The mean AIF-1 levels were higher in diabetics compared to controls. There were highly significant statistical difference between the all studied groups regarding AIF-1(P<0.001). As regards correlation between AIF 1 and other studied parameters in group II (diabetic without nephropathy). there were significant positive correlation between AIF-1, DBP, HbA1c, cratinin and microalbumin but negative correlation between AIF-1 and eGFR in group II But there was no significant correlation between AIF-1 and (weight, systolic blood pressure , mean blood pressure, urea) in group II. As regards correlation between AIF 1 and other studied parameters in group III (diabetic with nephropathy) There were significant positive correlation between AIF-1and microalbumin and negative correlation between AIF-1and eGFR and height in group III. But there was no significant correlation between AIF-1 and (age, weight, systolic blood pressure, diastolic blood pressure, mean blood pressure, urea, creatinin and HbA1c) in group III. Receiver operating characteristic (Roc) graph revealed that the best cut off level of serum AIF-1to differentiate between diabetic without nephropathy (group II) and diabetic with nephropathy (group III) 84.5ng/ml, at this level, the diagnostic sensitivity was 100 %, diagnostic specificity was 91.4%, the diagnostic accuracy was 95.7%, the positive predictive value was 92.1% and the negative predictive value was 100 %.