الفهرس 
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Abstract
The past two decades have seen an explosive increase in the number of people diagnosed with diabetes mellitus worldwide, particularly type 2 diabetes mellitus (T2DM), which is found associated with modern lifestyles, abundant nutrient supply, reduced physical activity, and obesity. The etiology of human T2DM is multifactorial, with genetic background and physical inactivity as two critical components. Inflammatory cytokines are key regulators of immune responses. Therefore, neutralizing inflammatory cytokines or antagonizing their receptor function is considered as a useful therapeutic strategy to treat T2DM. H. Pylori in the human stomach cause chronic gastritis, peptic ulcers, and gastric cancers. H. Pylori infection also induces insulin resistance and has been defined as a predisposing factor to T2D development.
Aim of work:
The present study aimed to evaluate the association between cytokines and H. pylori infection with T2DM and treated patients by detect T2DM markers; lipid profile; liver; kidney; cardiac functions; CRP; adipocytokines (leptin and adiponectin); cytokines (TNF-α, IL-18, IL-23 and IL-35) in recently diagnosed diabetics and diabetic treated patients compared with corresponding controls. As well as correlation analysis between H. Pylori IgG, T2DM markers and cytokines.
Materials and Methods:
A study was conducted on 127 participants allocated as normal healthy subjects (25) and 102 patients diagnosed as T2DM. The diabetic patients were subdivided into six groups according to metformin administration as mono-or dual therapies. In controls and all diabetic treated groups, H. Pylori IgG, fasting blood glucose (FBG), postprandial blood glucose (PPBG), HbA1c, fasting insulin, c-reactive protein (CRP) were estimated. IL-18, IL-23 and 35 were performed using quantitative RT-PCR, adipocytokines (leptin and adiponectin) and TNF-α were performed using ELISA techniques. In addition, lipid profile (total cholesterol, triglycerides, HDL-c, LDL-c, vLDL-c concentration), ALT, AST, CK, LDH, creatinine, microalbuminurea were measured.
Results:
The treatment of diabetic patients with metformin mono- and dual therapies showed an ameliorative effect in HbA1c, TNF-α, IL-18, IL-23, leptin, CRP, HDL-cholesterol, adiponectin and IL-35 values compared to diabetic non-treated ones. Moreover, diabetic non-treated patients exhibited a significant elevation in total and LDL-cholesterol levels, H. Pylori IgG, TNF-α, IL-18, IL-23, leptin and CRP as well as a noticeable decrease in HDL-cholesterol, adiponectin and IL-35 values compared to the healthy patients. .
Conclusions:
T2DM was correlated significantly with dyslipidemia and H. Pylori infection. Patients with established T2DM and H. Pylori infection, had a different cytokine profile than controls. Levels of TNF-α, CRP, leptin in serum and mRNA expression of IL-18 and IL-23 in the blood of non-treated diabetics were significantly elevated. One the other hand, IL-35 mRNA expression was down-regulated in diabetics as compared to normal control. The amelioration in inflammatory biomarkers was associated with improvement in glycemic control.