تقييم الكايميز والأنجيوتنسين II في تطور النوع الثاني لمرضى السكري المصابين بالاعتلال الكلوي

Evaluation of the Chymase and Angiotensin ll in the development of Type 2 Diabetic Nephropathy

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
This study aims to investigate the association between chymase and angiotensin ll levels in type 2 diabetic patients with early and chronic diabetic nephropathy, As well as study the effect of gender, body mass index, duration of disease, and age groups on the values of the variables studied with other variables in patients and healthy people and also researching, are there statistically significant differences between the levels of chymase and angiotensinogen and type 2 diabetes patients with early and chronic diabetic nephropathy
A case-control study of individuals with type 2 diabetes was conducted from November 2021 to May 2022. This study was conducted on 62 patients with type 2 diabetes who attended Imam Hussein Medical City in Karbala. and 28 cases in the control group. They were divided into three groups according to the ratio of their urinary albumin to creatinine ratio (ACR), the first group (Normoalbuminuria) where the ACR was less than 30 and their number was 22 patients, and the second group (Microalbuminuria) was the ACR (30-299) and their number was 20 patients and the group the third (Macroalbuminuria), where the ACR was greater or equal to 300, and their number was 20 patients, as well as they, were divided into four groups according to their body mass index, the first group (BMI less than 18) their number was 4, and the second group (BMI 18-24.9) their number 10 and the group The third group (BMI 25-29.9), numbered 21, and the fourth group (BMI greater or equal to 30), numbered 27 patients, and they were also divided into three groups according to age, the first group was age (35-45) and their number was 11, and the second group (age 46-60 And their number is 26, and the third group (age over 60) and their number is 25. They were also divided into three groups according to the duration of the disease, the first group (the duration of the disease is less than 5 years) and their number was 13, and the second group (the duration of the disease is 5-10 years) and their number is 16 and the third group (The duration of the disease is greater than 10 years) and their number was 33, and they were divided by gender into 35 males and 27 females.
The biochemical study included the patient and control group. Measure levels of fasting sugar (FBS), glycated hemoglobin (HbA1c), blood urea, Serum Creatinine, albumin-creatinine ratio (ACR), Microalbuminuria, cholesterol (CHOL), triglyceride (TG), and high-density lipoprotein (HDL) levels were also measured low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), Chymase and AngiotensinII.
This study showed a highly significant difference (P≤0.01) in fasting sugar (FBS), glycated hemoglobin (HbA1c), blood urea, Serum Creatinine, Microalbuminuria, albumin-creatinine ratio (ACR), cholesterol (CHOL), triglyceride (TG), and high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), High-density lipoprotein (HDL), Chymase and AngiotensinII, Between diabetic patients and the control groups.
This study also showed according to the effect of age in (FBS, blood urea, HbA1c, CHOL, LDL, VLDL, AngiotensinII Microalbuminuria, albumin-creatinine ratio (ACR)) there were statistically significant differences between the first and second group, as well as between the first and third groups. As for (TG, serum creatinine, HDL, and Chymase), there were statistically significant differences between the first and third groups.
This study also showed the effect of body mass index, In (TG, VLDL, and Duration of the disease) there were statistically significant differences between each of the first and fourth groups, the first and third, and the second and fourth, as well as we noticed in the (blood urea, Microalbuminuria, albumin-creatinine ratio (ACR), serum creatinine and Angiotensin II) significant differences between the first and fourth group, and also in (HDL, LDL, FBS, CHOL, HbA1c) there were statistically significant differences between the first and fourth group, and the second and fourth, and in the( Chymase) there were statistically significant differences in the first and fourth group, the second and fourth group, and the third and fourth groups.
This study also showed according to the effect of disease duration, On (HDL, LDL, FBS, CHOL, HbA1c, Microalbuminuria, albumin-creatinine ratio (ACR), TG, and VLDL), there were statistically significant differences between all groups, as well as we noticed in (blood urea, serum creatinine, AngiotensinII, and Chymase) statistically significant differences between the first and third, and second and third groups.
The study of the Comparison between type 2 Diabetes Mellitus with Diabetic Nephropathy groups for Biochemical Parameters showed In( HDL, LDL, FBS, CHOL, HbA1c, Macroalbuminuria, TG, VLDL, blood urea, serum creatinine, and Angiotensin II ), there were statistically significant differences between all groups, as well as in the Chymase it was statistically significant differences between the first and third and second and third groups.
The results showed that there was a significant positive correlation between the blood levels of HbA1c, FBS, blood urea, serum creatinine, Microalbuminuria, CHOL, TG, LDL, VLDL Opposite Chymase, and ANGII levels of the patients, The study also showed a negative linear regression between Chymase and ANGII with HDL.