الفهرس 
TYPE 1 DIABETES MELLITUSOnly 14 pages are availabe for public view
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Abstract
T
he exact mechanism behind diabetic nephropathy remains unknown. The link between vascular complications of diabetes and oxidative stress is an avid field of research and recent studies have indicated that augmented oxidative stress may play a role in the development and progression of diabetic complications including DN.
Several animal models and studies among adults with type 2 diabetes have evaluated the role of oxidative stress in the pathogenesis and progression of DN, however data regarding the role of oxidative stress in DN among children and adolescents with T1D is limited.
Thus, the aim of the current interventional study was to evaluate the oxidant/antioxidant status in children and adolescents with DN. Furthermore, the study aimed to evaluate the role of alpha-lipoic acid as an adjuvant antioxidant therapy for diabetic nephropathy in children and adolescents with type l diabetes.
The current study included 100 patients with T1D; equally divided into 2 groups according to urinary albumin excretion rate (UAER). Both groups of T1D were compared with age and gender matched healthy controls.
Data from the current study showed that MDA levels were significantly higher in patients with DN (9.24 nmol/ml) compared with patients with normoalbuminuria (1.99 nmol/ml) and healthy controls (0.78 nmol/ml) (P< 0.001). Unlike MDA, TAC levels were significantly lower in patients with T1D compared to healthy subjects. Among participants with T1D, TAC levels were significantly higher among patients with DN (P< 0.001). A significant negative correlation was found between MDA and TAC levels (r=-0.655, P< 0.01). Furthermore, a significant positive correlation was elicited between MDA and both HbA1C (r=0.5, P< 0.001) and UAER (r=0.7, P< 0.001) and a significant negative correlation was elicited between TAC and both HbA1C (r= -0.64, P< 0.001) and UAER (r=- 0.88, P< 0.001).
When evaluating the role of adjuvant ALA in the current study, the interventional arm, compared to the arm receiving the standard of care, showed a significant reduction in MDA (P< 0.001), additionally, TAC significantly increased at the end of the study(P<0.001). The changes were coupled with a significant reduction in UAER and HbA1c (P< 0.001).
Oxidative stress significantly contributes to the pathogenesis of DN and better understanding of the oxidant/anti-oxidant status in DN could pave the way for novel therapeutic targets including adjuvant antioxidants. Supplementation of ALA as an adjuvant antioxidant therapy was well tolerated and mitigated oxidative stress, improved glycemic control and had a protective role on kidney tissues against diabetes-induced oxidative damage.