BACKGROUND: Diabetes mellitus (DM), especially type 2, represents one of the most important health problems worldwide and, according to recent estimations, it is likely to worsen to critical levels in the next decades, with the great concern that this disease is rising rapidly in younger population groups, including children and adolescents. Oxidative stress is an important factor in the etiology and pathogenesis of diabetes mellitus. Intercellular adhesion molecule-1: Intercellular adhesion molecule-1 (ICAM-1), also known as CD54, is an endothelial and leukocyte associated transmembrane protein with relevance in stabilizing cell-cell interactions and facilitating leukocyte endothelial transmigration. It is constitutively present in the membranes of leukocytes and endothelial cells; upon cytokine stimulation, the concentrations greatly increase. ICAM-1 ligation produces pro-inflammatory effects such as inflammatory leukocyte recruitment by signaling through cascades involving a number of kinases.
AIM OF THE WORK: In this study, we attempt torelationship between sICAM-1 (intercellular adhesion molecule-1) and diabetic nephropathy as an important marker in inflammation, immune responses and in intracellular signaling events. we determined plasma concentration of ICAM-l, serum malondialdehyde (MDA), superoxide dismutase (SOD), Serum nitric oxide (NO) as a marker for endothelial activation among   type- 2 diabetic patients with or without nephropathy and oxidative stress as a marker (as tool in early diagnosis of nephropathy as major diabetic complications) also to explore the relationship between plasma level of ICAM-l and insulin resistance in the studied patients.
PATIENTS AND METHODS: This study carried out on 100 male individuals. Their age ranged from 25- 60 years. They were classified as follows:Control group: 30 apparently healthy adult males. Patients groups: 70 patients suffering from type 2 diabetes mellitus, Patients were subdivided into two groups. Group I:35 patients with type 2 diabetes mellitus with normal albuminuria without complications.Group II:35 patients with type 2 diabetes mellitus with nephropathy.
RESULTS: This study has found a strong relationship between sICAM-1     (intercellular adhesion molecule-1) and diabetic nephropathy. It has been shown that inflammation has a role in the development of diabetic nephropathy, so sICAM-1 may play a role in the development of diabetic nephropathy. Our results also, show strong direct correlation between ICAM-1 and insulin resistance which supports the conclusion that insulin resistance may be a factor contributing to the increase plasma levels of adhesion molecules. In accordance to our results the metabolic syndrome and type 2 diabetes are associated with endothelial activation, but the mechanisms that underlie these associations are not fully understood.