الفهرس 
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Abstract
The present study aimed to clarify the potential role of urinary periostin as a predictor of nephropathy in patients with type 2 diabetes mellitus and to evaluate its relation to clinical and laboratory parameters. This study included 80 subjects divided into four groups: • group I: 20 normal subjects as a control group. • group II: 20 type 2 diabetic patients with normoalbuminuria. • group III: 20 type 2 diabetic patients with microalbuminuria. • group IV: 20 type 2 diabetic patients with macroalbuminuria. All cases were subjected to the following: - Full history taking and duration of the disease. - Complete clinical examination. - Abdominal ultrasonography. - Fundus examination. - Laboratory investigations including: A. Routine investigations: • Complete urine analysis. • Fasting and postprandial blood glucose. • Glycosylated hemoglobin percentage (Hb A1c %). • Lipid profile. • Urinary albumin to creatinine ratio. • Blood urea. • Serum creatinine. • Estimated glomerular filtration rate. B. Specific investigations: • Urinary periostin level. The results obtained from this work were tabulated before and statistically analyzed. The main findings can be summarized as follow: • There was no statistically significant difference in the sex, age & duration of diabetes between the studied groups. • The mean fasting blood glucose was statistically significantly higher in patients with macroalbuminuria as compared to the control, normoalbuminuria & microalbuminuria groups. Also, the mean fasting blood glucose was statistically significantly higher in patients with microalbuminuria as compared to the control group. • The mean 2-h postprandial blood glucose was statistically significantly higher in patients with macroalbuminuria as compared to the control & normoalbuminuria groups. Also, the mean 2-h postprandial blood glucose was statistically significantly higher in patients with microalbuminuria & normoalbuminuria as compared to the control group. • The mean HbA1c was statistically significantly higher in patients with macroalbuminuria as compared to the control, normoalbuminuria & microalbuminuria groups. Also, the mean HbA1c was statistically significantly higher in patients with microalbuminuria & normoalbuminuria as compared to the control group. • The mean blood urea was statistically significantly higher in patients with macroalbuminuria as compared to the control and normoalbuminuria groups. Also, the mean urea was statistically significantly higher in patients with microalbuminuria as compared to the control group. • The mean serum creatinine was statistically significantly higher in patients with macroalbuminuria as compared to the control, normoalbuminuria & microalbuminuria groups. Also, the mean serum creatinine was statistically significantly higher in patients with microalbuminuria as compared to the control & normoalbuminuria groups. • The mean UACR was statistically significantly higher in patients with macroalbuminuria as compared to the control, normoalbuminuria & microalbuminuria groups. Also, the mean ACR was statistically significantly higher in patients with microalbuminuria as compared to the control & normoalbuminuria groups. • The mean eGFR was statistically significantly lower in patients with macroalbuminuria as compared to the control & normoalbuminuria groups. Also, the mean eGFR was statistically significantly lower in patients with microalbuminuria as compared to the control & normoalbuminuria groups. • The mean urinary periostin level was statistically significantly higher in patients with macroalbuminuria as compared to the control, normoalbuminuria & microalbuminuria groups. Also, the mean urinary periostin level was statistically significantly higher in patients with microalbuminuria as compared to the control and normoalbuminuria groups. Moreover, it was statistically significantly higher in normoalbuminuric group as compared to control group. • Urinary periostin level was positively correlated with duration of diabetes, blood pressure, fasting blood glucose, 2-hour post prandial blood glucose, glycosylated hemoglobin, urinary albumin/creatinine ratio, blood urea, serum creatinine, total cholesterol, LDL-C and triglycrides but negatively correlated with eGFR and HDL-C. Conclusion from this work, it could be concluded that: • An increased urinary periostin level is considered as an early predictor for deterioration of renal function in diabetic patients, suggesting that periostin can be used to identify diabetics at risk for diabetic kidney disease development. Clearly, further well-designed prospective studies are required to prove this hypothesis.