Introduction Diabetic nephropathy (DN) is a significant medical problem because of its increasing incidence, morbidity and mortality. DN is a microvascular complication of diabetes mellitus (DM) that has been observed in 30%–40% of type 1 DM and 10%–20% of type 2 DM patients. Recent studies focus on novel diagnosis and treatment strategies for DN to decrease its mortality and morbidity. New biomarkers such as endocan are considered to be associated with endothelial dysfunction, angiogenesis and inflammation and may be reliable markers for early detection and progression of DN. Aim This study aimed to establish the role of endocan as a marker of DN similar to the case with the urine albumin–creatinine ratio. Patients and methods This study has been carried out on 60 diabetic patients selected from the inpatient department and outpatient clinics of the Department of Internal Medicine in Dikirnis General Hospital and 30 healthy controls who fulfilled the inclusion and exclusion criteria. The selected participants were divided into three groups: group 1 included 30 healthy controls, group 2 included 30 diabetic patients with normoalbuminuria and group 3 included 30 diabetic patients with microalbuminuria or macroalbuminuria. Results In this study, there was no correlation between endocan and serum creatinine levels as well as estimated glomerular filtration rate in diabetic patients with proteinuria. Patients with microalbuminuria in this study had insignificantly lower endocan levels (111.9±85.7) than patients with normoalbuminuria (130.7±76.3). Conclusion Here, in this study, serum endocan did not have considerable specificity or sensitivity in early detection or progression of DN.

Background Vascular stiffness is common among patients with end-stage renal disease (ESRD). Circulating markers of bone formation play an important role in evaluating bone-mineral disease state as well as in predicting the risk of developing vascular calcification and hence, arterial stiffness. Aims This study aimed to assess arterial stiffness in maintenance hemodialysis patients using pulse wave analysis as an index of central and peripheral arterial stiffness and serum procollagen type I N-terminal propeptide (P1NP) as a marker for bone turnover. Patients and methods Fifty ESRD patients aged 18 years old or more who have been assigned to regular long-term hemodialysis were included in this study and subjected to complete history taking and physical examination and laboratory investigations including lipid profile, fasting plasma glucose level (mg/dl), serum creatinine, blood urea (mg/dl), serum phosphorus (mg/dl), serum calcium (mg/dl), P1NP (ng/ml), serum parathyroid hormone (PTH) (pg/ml), and serum bone-specific alkaline phosphatase (BALP) (U/l), and aortic pulse wave velocity. Results There was significant positive correlation between P1NP and PTH (P≤0.01) and between BALP and serum PTH (P≤0.01). There was significant difference between patients with low and high augmentation index regarding BALP (P=0.018). Conclusion ESRD patients have a high prevalence of vascular stiffness assessed by pulse wave analysis. There is a significant correlation between BALP and PTH and between P1NP and PTH. There is a relation between markers of bone formation and vascular stiffness.

Background S100P, a binder of receptors for advanced-glycation end products, is an established biomarker of many types of cancer. However, data regarding its role in diabetes and diabetic peripheral neuropathy (DPN) are unclear. Aim The aim of this work was to study the relationship between serum S100P and DPN in patients with type-2 diabetes mellitus (T2DM). Participants and methods This cross-sectional study included a total of 90 subjects divided into three groups: 30 patients with T2DM complicated with peripheral neuropathy (group A), 30 patients with T2DM without peripheral neuropathy (group B), and 30 subjects as healthy-control group (group C). All patients with T2DM were assessed for peripheral neuropathy using Michigan neuropathy screening instruments and nerve-conduction study was done to diagnose subclinical neuropathy. Serum S100P was assessed by enzyme-linked immunosorbent assay technique. Results Mean serum S100P levels in group A and group B were significantly lower compared with group C (P<0.001 for both comparisons). However, there was no significant difference in mean serum S100P levels between groups A and B (P=0.394). Conclusion Serum S100P is significantly low in T2DM with no significant association with DPN.