Background: Serum copeptin, the terminal part of the arginine vasopressin (AVP), is stable in plasma. The AVP is increased in diabetic patients and may play a role in the development of diabetic kidney disease. Objective: To evaluate the role of serum copeptin in the diagnosis of diabetic nephropathy in type-2 diabetes mellitus. Patients and Methods: 40 type-2 diabetes mellitus (T2DM) patients; divided into two groups, (20 with poor glycemic control, and 20 with good glycemic control), in addition to 20 non-diabetic healthy control subjects. The following investigations had been made; HbA1C, FBS, blood urea, serum creatinine and sodium, creatinine clearance (Ccr), glomerular filtration rate (eGFR), urinary protein, and urinary sodium. Serum copeptin levels were measured using an enzyme-linked immunoassay (ELISA). Results: Serum copeptin levels were significantly higher in (T2DM) patients with poor glycemic control than in (T2DM) patients with good glycemic control compared to the healthy control group. There was a significant positive correlation between serum copeptin and FBS, HbA1C, blood urea, serum creatinine, urinary Na, and 24-hour urinary protein, and a significant negative correlation with serum Na, eGFR, and creatinine clearance. The receiver operating characteristic (ROC) curve for the validity of serum copeptin, as a marker for diabetic nephropathy, at cutoff point 3452 pg/ml, showed 90% sensitivity, and 95% specificity. Conclusion: Serum copeptin is independently related to markers of kidney injury in T2DM and may be used as a marker for diabetic nephropathy.
Background: Atherosclerosis as a complication of diabetes, is considered to be a chronic inflammatory disease, developing over years and proceeding through many steps. Adiposity fatty acid-binding protein (A-FABP) is highly expressed in mature adipocytes and plays a central regulatory role in energy metabolism and inflammation. A-FABP mRNA expression in adipose tissues predicted coronary artery disease in homozygous subjects. A-FABP may also play a role in the development of atherosclerotic diseases in humans. Objective: To detect the relationship between serum A-FABP level and carotid intima-media thickness (IMT) as indicator of atherosclerosis in patients with type 2 diabetes mellitus. Patients and methods: 124 patients with type 2 diabetes (T2D), were divided into two groups: Group 1: 62 patients with T2D ≤ 5 years duration, and Group 2: 62 patients with T2D > 5 years duration. They were subjected to full history taking, clinical examination, and laboratory investigations in the form of CBC, LFT, KFT, HBA1c, fasting and postprandial blood sugar, A-FABP serum level, and carotid Doppler. Results: Serum level A-FABP and carotid IMT was significantly higher in long standing diabetes group compared to short standing diabetes group. A-FABP cutoff was proven to have a high sensitivity 94.4%, specificity 100.0%, positive predictive value of 100.0%, negative predictive value of 97.7% and overall accuracy of 98.3% regarding the prediction of atherosclerosis. Conclusions: A-FABP serum level have a high sensitivity, specificity, predictive value and overall accuracy regarding atherosclerosis, and should be recommended as a part of routine surveillance for atherosclerosis in patients with type 2 diabetes.
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