This study was designed to assess the relationship between serum levels of anti-Müllerian hormone and 25-hydroxy vitamin D in chronic kidney disease male patients. For that, serum 25-hydroxy vitamin D and anti-Müllerian hormone along with follicle-stimulating hormone, luteinising hormone, prolactin, total testosterone and estradiol were assayed in 59 patients with different stages of chronic kidney disease and 21 healthy participants. Compared to controls, serum levels of anti-Müllerian hormone and 25-hydroxy vitamin D were significantly decreased in patients with chronic kidney disease. The decreased anti-Müllerian hormone level correlated positively with estimated glomerular filtration rate and serum levels of testosterone and 25-hydroxy vitamin D. Meanwhile, it was negatively correlated with age and serum levels of urea, creatinine, follicle-stimulating hormone, luteinising hormone and prolactin. 25-Hydroxy vitamin D and luteinising hormone explained the 65.9% variability of anti-Müllerian hormone in a multiple linear regression model. However, anti-Müllerian hormone in crude correlation was more strongly associated with serum 25-hydroxy vitamin D than luteinising hormone. In conclusion, serum level of 25-hydroxy vitamin D might be a determinant factor of anti-Müllerian hormone level, and their relationship might explain in part the dysfunction of Sertoli cells and the impaired testicular functions in chronic kidney disease male patients.

Background: Netrin-1 is a laminin like protein highly induced after acute and chronic kidney injury, represent tubular damage and excreted in urine of both animals and humans. Netrin-1 is a potential biomarker predicting the development of diabetic kidney disease. Interleukin-6 (IL-6) is an inflammatory cytokine that has a role in the transformation from acute to chronic inflammation. The aim of this work was to evaluate the role of Netrin-1 and IL-6 in the development of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods: Our study included 75 patients with T2DM and 25 healthy control group. The study duration started from October 2019 to January 2021. Participants were subdivided into four equal groups: group I: 25 healthy subjects as control group, group II: 25 diabetic patients with albumin/creatinine ratio < 30 mg/g, group III: 25 diabetic patients with albumin/creatinine ratio 30-300 mg/g, group IV: 25 diabetic patients with albumin/creatinine ratio > 300 mg/g. All subjects underwent complete clinical examination, laboratory investigations and measurement of serum Netrin-1 and IL-6 by ELISA. Results: Nertin-1 was significantly higher in group III and group IV than group II and control group (P<0.001*). Netrin-1 was positively correlated with IL-6, fasting BG, 2HPP, HbA1C, B. urea, S. creatinine and urinary ACR, but it was negatively correlated with eGFR, Hb and S. albumin. IL-6 was significantly higher in group IV than group III, group II and control group (p<0.001*). There was a positive correlation between IL-6 and 2HPP, HbA1C, B. urea, S. creatinine and urinary ACR, but there was a negative correlation between IL-6 and eGFR, Hb and S. albumin. Netrin-1 was more sensitive 96.5% and more specific 99.8% than IL-6 sensitivity 83.3% and specificity 85.0%. Conclusions: Netrin-1 and IL-6 were significantly higher in diabetic nephropathy patients with macroalbuminuria than other groups. Netrin-1 was more sensitive and specific than IL-6 in predicting DN and its progression.

Aims: To assess hepatic steatosis and fibrosis in patients of type 2 diabetes mellitus (T2DM), their possible risk factors and their association with metabolic syndrome and micro or macro-albuminuria. Study Design: Cross sectional study. Place and Duration of Study: Outpatient Clinic of Diabetes, Metabolism and Endocrinology Unit in internal medicine department, Tanta University, Egypt in a period between September 2019 to March 2020. Methodology: We included 200 patients had a diagnosis of T2DM according to American Diabetes Association criteria. Then patients were assessed for presence of hepatic steatosis and fibrosis using fibroscan and we used liver stiffness measurements (LSMs, as a measure of fibrosis) and controlled attenuation parameter (CAP, as a measure of steatosis) and routine laboratory data were done to rule out possible risk factors. Results: 98.5% of participants had hepatic steatosis and 53.5% of participants had hepatic fibrosis. Those patients had longer duration of DM, higher BMI, bad control of T2DM, higher lipid profile values, association with metabolic syndrome, micro and macro-albuminuria and non-significantly elevated liver enzymes. Conclusion: Hepatic steatosis and fibrosis are highly prevalent in patients with T2DM, incidence of hepatic steatosis and fibrosis is positively correlated with longer duration of DM, higher BMI, bad control of DM, dyslipidemia, presence of metabolic syndrome, diabetic nephropathy, weakly correlated with liver enzymes. TE is an accurate and non-invasive tool to be used in screening for hepatic steatosis and fibrosis ,so we recommend screening for hepatic steatosis and fibrosis using fibroscan to help in early management and prevent its progression into liver cirrhosis.