الفهرس 
Introduction
Diabetes mellitus and its complicationsOnly 14 pages are availabe for public view
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Abstract
This study included one hundred and sixty diabetic patients ( 75males and85 females) recruited from Department of Internal Medicine and outpatient clinics of ophthalmology at Assiut University Hospitals. Their age ranged from 23-89 with mean value 52.53± SD13.84 .Also, forty apparently healthy individuals (16 males and 24 females) were included as a control group (group1). Their age ranged from 20-67 years with a mean value of 38.05± SD13.84. Serum glucose, kidney functions, lipid profile, electrolytes, uric acid were done for all patients and controls. In addition HbA1c , albumin/creatinine ratio and protein in urine /24h were also performed.
Patients were classified into four groups:
group (2):
Twenty two diabetic patients without complications.
group (3):
Eighty three diabetic patients with nephropathy.
group (4):
Fifteen diabetic patients with hypertension
group (5):
Forty diabetic patients with retinopathy and nephropathy.
*According to microalbumin , the diabetic patient groups(diabetic patients without complications, diabetic patient with hypertension and diabetic patient with retinopathy and nephropathy )were classified into :-
group A:diabetic patients with normoalbuminuria(65 patients)
group B:diabetic patients with microalbuminuria (12 patients)
*According to 24-hour urinary protein, diabetic nephropathy patients were classified into:
1-Diabetic nephropathy patients with microalbuminuria (proteinuria<500 mg/day) (n= 63) group(3-I)
2-Diabetic nephropathy patients with macroalbuminuria (proteinuria≥500 mg/day)(n= 20) group(3-II)
*According to glycosylated haemoglobin the whole diabetic patients were classified into three groups: “Good control” (HbA1c <7%), “Fair control” ( HbA1c 7 -9% HbA1c) and “Poor control” (HbA1c > 9%) (International Diabetes Federation ,2012).
*According to sex , the studied controls and patients were classified into two groups.
Results of anthropometric measures in the studied groups:
There were statistically significant elevations of BMI in groups2,3,4,5 compared to controls. No statistically significant difference was found in comparing the patient groups with each other.
There were statistically significant elevations of WHR in groups 2, 3, 4, 5 compared to controls. Significant elevations of WHR were also observed in comparing groups 3 versus both groups 2 and 5 .
Results of laboratory investigations:-_
1-Serum glucose
There were statistically significance elevations of serum glucose in all patients groups compared to control group .In group (5) there was statistically significant elevation in the mean value of serum glucose compared to group (2) . Otherwise, no significant differences were found.
2-HbA1c
There were statistically significant elevations of HbA1c in all patients groups compared to control group also in groups 3,4,5 compared to group 2 and in group 4 versus 3 .
There were statistically significant elevations of s.urea in patient groups 3,4,5 compared to controls . Also, significant elevations were found in groups 3,5 compared to group 2 and in group 3 versus both groups 4,5 .
There were statistically significant elevations of s.creatinine in group3 and group 4 compared to control group . On comparing patients groups, significant elevation was found in groups 3 versus group2 ,4 and 5 .
There was reduction of creatinine clearance in all patients groups compared to controls but, this reduction was significant only in group 3 and 4. On comparing patients groups, there were significant reduction of creatinine clearance in groups 3 and group 4 versus group 2 also in group 3 versus group 4.No significant difference was found in comparing other groups.
There were statistically significant elevations of ACR in groups 5 compared to controls and group (4). Otherwise, no statistically significant differences were found.
*In group 3(DM with nephropathy ) the protein in urine/24h ranged from 61 - 1958 mg with a mean value of 331.27 ± 337.72.
4-Serum Uric acid (mg/dl):
There were statistically significant elevations of serum uric acid in all patient groups (2,3,4,5) compared to control. Also, There were statistically significant elevations of uric acid levels in group (3) versus groups 2,4, 5.
5-Serum electrolytes :
Serum sodium levels showed no statistically significant difference in all patient groups when compared to control group and to each other . There were statistically significant elevations of serum potassium in groups 2,3 ,5 compared to controls and in group (2) versus (5) . But, there was no statistically significant difference in other groups when compared to each other .
In group (2), there was statistically significant reduction in serum magnesium level compared to control group .Otherwise; no statistically significant difference was found in comparing other groups .
There were statistically significant reduction of serum calcium in groups 2,3,5 compared to controls . But, serum calcium levels showed no statistically significant difference in all patients groups when compared to each other.
6-Lipid profile:
The level of serum cholesterol showed no statistically significant difference in all patient groups when compared to control group and to each other .
There were statistically significant elevations of serum triglycerides in groups 2,4,5 compared to controls . The mean value of TG shows statistically significant elevation in group (5) versus group (3) ,(4).There were no statistically significant difference in comparing the other groups with each other .
There was statistically significant decrease of HDL-c in group (2) and group (5) compared to controls .Otherwise serum HDL-c levels showed no statistically significant difference on comparing other groups .No statistically significant difference was observed on comparing LDL-c values between all patient groups versus each other and controls.
Results according to microalbumin in the diabetic patient groups(diabetic patients without complications, diabetic patient with hypertension and diabetic patient with retinopathy and nephropathy ).
1-Results of anthropometric measures in diabetic patients with normoalbuminuria, microalbuminuria and in control group
The mean value of BMI showed statistically significant elevation in patient groups(A,B) when compared with controls . No statistically significant difference was found in patient groups when compared each other .
The mean value of WHR show statistically significant elevation in groups A when compared with control .No other statistically significant difference was found.
2-Lipid profile indiabetic patients with normoalbuminuria,microalbuminuria and in control group:
The mean value of cholesterol showed statistically significant elevation in group B when compared with control . No statistically significant difference was found in group (A)when compared with control and between the groups with each other.
The mean value of triglyceride showed statistically significant elevation in group A and group B when compared with control .
The mean value of HDL show statistically significant decrease in group A when compared with control. Otherwise no statistically significant differences were found.The mean value of LDL show statistically significant elevation in group B when compared with control and group A.
Serum uric acid levels in diabetic patients with normoalbuminuria, microalbuminuria and in control group:
Serum uric acid levels showed statistically significant elevation in groups (A,B) when compared with control group .
Results of diabetic nephropathy patients classified according to 24-hour urinary protein .
1-Results of anthropometric measures ,serum uric acid and lipid profile in the studied patient groups:
No statistically significant differences were found in anthropometric measures ,serum uric acid and lipid profile in studied patient groups.
Results of the studied patients group classified according to HbA1c
Results of whole diabetic patients classified according to glycosylated haemoglobin .
1-Results of anthropometric measures in the studied groups:
No statistically significant difference was found in anthropometric measures in studied patient groups versus each other.
2-Serum Uric acid :
No statistically significant differences were found in the level serum uric in diabetic patient groups classified according to HbA1c.
3-The lipid profile:
The mean value of serum TG showed statistically significant elevation in poorly controlled group when compared with good controlled group.The mean value of serum cholesterol, HDL and LDL showed no statistically significant difference in all patients groups when compared with each other .
Serum uric acid level in control and studied patients groups classified according to the sex (number of males and females) in each group .
The mean value of serum uric acid showed no statistically significant differences between the males and females in studied patient groups.
Correlation between the variables in studied patient groups:
Diabetic patients without complications (group 2):
Significant positive correlation was found between serum uric acid with serum cholesterol and LDL.Also, There were significant positive correlation between BMI with serum cholesterol and serum triglycerides .
Diabetic patients with nephropathy(group3):
There were significant positive correlation between serum uric acid and serum urea, serum creatnine , triglycerides and 24 hour protein in urine . Also, there was \significant positive correlation between BMI with WHR.
There was significant negative correlations between creatinine clearance and uric acid level . All other variables showed non significant correlation with uric acid.
Diabetic patients with hypertension (group 4):
There was significant positive correlation between BMI and WHR. There was significant positive correlation also between serum creatinine and LDL and serum uric acid .
A significant negative correlation between serum uric acid and creatinine clearance was found .
Diabetic patients with retinopathy (group 5):
There was significant positive correlation between serum uric acid and serum creatinine .A significant negative correlation between creatinine clearance , LDL and uric acid was found.All other variables showed non significant correlation with uric acid.