Evaluation of Apelin Level in Type 2 Diabetic Patients with Peripheral Neuropathy and Nephropathy

Abstract
Background: Diabetic Peripheral Neuropathy (DPN) and Diabetic Nephropathy (DN) are serious complications of diabetes mellitus. Their pathogenesis is associated with dura-tion of diabetes, hyperglycemia and increased pro-inflammatory response that cause endothelial dysfunction and impaired angiogenesis. Apelin is an endogenous peptide which is expressed in the kidney, adipose tissue, liver, endothelium, and plasma. It contributes to endothelial dysfunction, angio-genesis, and inflammation that lead to pathogenesis of DPN and DN.
Aim of Work: To assess serum apelin level in type 2 diabetic patients with peripheral neuropathy and nephropathy.
Patients and Methods: 80 subjects were selected from Nasser Institute for Research and divided into four groups: Group 1 included 20 healthy controls, group 2 included 20 diabetic patients without complications, group 3 included 20 patients with DPN and group 4 included 20 patients with DN. They were subjected to monofilament test, fasting blood glucose, kidney function tests, HbA1c, lipid profile, liver profile, urine analysis, urinary albumin/creatinine ratio and serum apelin.
Results: Apelin levels are significantly higher in diabetic patients in the presence of neuropathy and nephropathy compared to other groups. There was a positive correlation between serum apelin and HbA1c in group 2 and 3. Further, there was a positive correlation between apelin level and HbA1c, serum creatinine and urine albumin/creatinine ratio in group 4. There was no correlation between serum apelin and other parameters in all studied groups.
Conclusion: Serum apelin may play an important role in pathogenesis of DPN and DN.