الفهرس 
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Abstract
This study was conducted on 60 adult subjects. This study was conducted in Clinical Pathology and Internal Medicine department (nephrology unit), Faculty of Medicine, Tanta University in Tanta. Our study was done on the following 3 groups. Patients were divided into 2groups according to their urinary albumin creatinine ratio (UACR). group I: patient with type 2 DM. with UACR<30 mg/gm (20 patients). group II: patient with type 2 DM. with UACR30-300mg/gm (20 patients). group III: Healthy controls (20 controls) (matched with other groups as regard the age, gender and body mass index). All patients and controls were subjected to: 1- Full history taking and clinical examination. 2- Routine laboratory investigation: • Fasting and 2 hours post prandial blood sugar. • Serum creatinine, • Urinary albumin creatinine ratio. • Glycated Hb A1c 3- Specific laboratory investigation: • Urinary Vitamin D Binding Protein by ELISA. The results of this study revealed that: The quantification results were obtained by correcting for creatinine expression and showed that urinary VDBP levels were significantly elevated in the patients of DN1 and DN2 groups compared with those of normal controls. In group I the level of urinary VDBP ranging from (111-182 μg/ml) (mean 136.200). In group II the level of urinary VDBP Cr ranging from (172-300 μg/ml)(mean 225.100). In group III the level of urinary VDBP ranging from (62-160 μg/ml) (mean 107.500). There was statistically significant increase in level of Urinary VDBP in females between groups (p-value<0.001). Receiver operating characteristic analysis of urinary VDBP levels for the diagnosis of DN rendered ROC curves were used to assess the potential utility of urinary VDBP detection in patients with DN. The area under the ROC curve of urine VDBP levels for the diagnosis of DN was 90%. The analysis rendered an optimum cut-off value of ≥ 136 μg/ml corresponding to77.50% sensitivity and 85.00% specificity. In conclusion, the findings of the present study suggest that urinary VDBP may be a potential biomarker for the early detection and prevention of DN. Further studies are required to examine the pathogenic mechanisms of elevated VDBP levels and their role in the diagnosis of DN.