CLINICAL SIGNIFICANCE OF PROCALCITONIN AND C-REACTIVE PROTEIN IN THE PREDICTION OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

  Objective: This work was delineated to assess procalcitonin (PCT) and C-reactive protein (CRP) as prognostic markers for cardiovascular complication in type 2 diabetic patients.Methods: Forty diabetic patients without cardiovascular disease (CVD), 40 diabetic patients with CVD, and 20 healthy control counterparts were participated in this study. Serum PCT and CRP levels were assayed and correlated with metabolic parameters. Receiver operating characteristic (ROC) curve analysis was done for each biochemical marker.Results: The mean level of PCT was 707.17±99.19 ng/l in diabetic patients versus 881.30±123.56 ng/l for the cardio-diabetic patients (p<0.0001). The mean value of CRP was 34.43±17.27 mg/l in diabetic patients versus 50.32±20.19 mg/l for the cardio-diabetic patients (p=0.0003). PCT levels were significantly amplified in the cardio-diabetic patients with increasing CRP, triglycerides (TG), fasting blood glucose (FBG), and cholesterol (p=0.004, 0.0005, 0.002, and 0.01, respectively). CRP levels were significantly enhanced in the cardio-diabetic patients with increasing TG, FBG, cholesterol, and microalbumin (p=0.002, 0.047, 0.003, and 0.001 respectively). ROC curve analysis for PCT and CRP revealed that the area under curve (AUC) was 0.878 and 0.727, respectively. These findings indicate the good validity of the above biomarkers especially PCT as a prognostic marker for cardiovascular complication in type 2 diabetic patients.Conclusion: This study evidences the usefulness of measuring serum levels of PCT and CRP in diagnosis of cardiovascular complication in type 2 diabetic patients

Clinical Utility of Melatonin in Fibromyalgia Diagnosis

       Fibromyalgia syndrome (FMS) is a chronic disease with an unknown etiology, which is characterized by reduced pain threshold (hyperallgesia) & pain with normally innocuous stimuli (allodynia).This diffuse pain is often disease associated  with wide range of  other symptoms including fatigue, sleep disturbance, stiffness& more.FMS often occur concomitantly  with other rheumatologic disease such as rheumatoid arthritis(RA), systemic lupus erthymatosus(SLE).       The pineal hormone melatonin (MT) exerts a variety of effects on the immune system. MT activates immune cells and enhances inflammatory cytokine and nitric oxide production.Methods: We were studied 75 subjects, 55 of subjects were FMS patients defined by the American Colleague of Rheumatology (ACR 2010) criteria. Patients' mean age was 32.5 ± 13.9 years. They were classified into two groups: Group I of 25  primary FMS patients . Group II of 30 secondary FMS patients with other rheumatologic disease such as RA, SLE. Twenty age and sex matched healthy individuals were included in the study as a control group.Results:Mean Melatonin titers were significantly reduced (p<0.0001) in primary FMs patients compared to the controls (21.32vs. 30.9 pg/ml), but they were significantly elevated (p<0.0001) in secondary FMS compared to controls (138.1vs.30.9 pg/ml). Our data imposed that, in 1ry FMS there were negative correlations of MT titers with tender points (r=-0.848**,p<0.0001), sleep disturbance(r=-0.963**, p< 0.0001**), Fatigue (r= -0.972**, p<0.001**), WPI (r= -0,953 **, p<0.0001) and SS (r=-0.901**, p< 0.0001). Conclusions:In primary FMS patients melatonin level is lower than melatonin level in control, but MT level is high in secondary FMS patients. There was a negative correlation between MT with tender points, sleep disturbance, fatigue, SS & WPI. But there was a positive correlation between MT & cognitive symptoms