Relation Between Plasma Apelin Level and Diabetic Nephropathy in Type 2 Diabetic Patients

Introduction Type 2 Diabetes Mellitus is a metabolic syndrome associated with hyperglycemia due to defect in secretion or action of insulin or both. Long term hyperglycemia leads to complications of microvasculature involving the eyes, kidneys and nerves.

Diabetic nephropathy (DN) is the commonest cause of end-stage renal disease that may need hemodialysis up to renal transplantation with increased incidence of mortality. Without management, patients with diabetes worsen from micro albuminuria to frank proteinuria with more impairment of kidney functions. This worsening develops in both type 1 and type 2 diabetes.Previous studies have revealed major roles of different inflammatory molecules in the development of diabetic nephropathy, including acute phase reactants, inflammatory cytokines, adhesion molecules, and chemokines.

Previous studies have revealed major roles of different inflammatory molecules in the development of diabetic nephropathy, including acute phase reactants, inflammatory cytokines, adhesion molecules.

Apelin (APLN) is the endogenous ligand peptide which is encoded in humans by the APLN gene. It is presented widely in different organs as the heart, kidney, liver, fatty tissue, endothelium, plasma, gastrointestinal tract, brain and adrenals .Apelin has a major role in the pathophysiology of hypertension, heart failure, cardio-vascular disease, DM, and obesity. Apelin is found to be higher in type 2 diabetic patients than healthy subjects. It inhibits insulin secretion, so it may precipitates impaired metabolism of glucose.

Also, Apelin present in omental fat is higher than its presence in subcutaneous fat suggesting its contribution to central obesity which is an important risk factor for type 2 DM.