الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus (DM) is one of the most common chronic diseases in the world. Egypt has one of the highest rates of diabetes globally. Long-term complications and organ damage caused by T2DM include retinopathy, nephropathy, neuropathy, and coronary artery disease (CAD). RBP4 is a small molecule combination protein with hydrophobic characteristics that is one of several transgenic proteins capable of transporting fat-soluble vitamins. RBP4 has been implicated in the etiology of insulin resistance and type 2 diabetes, according to evidence from animal and human research. RBP4 induces the expression of proinflammatory cytokines in mouse and human macrophages, and thus inhibits insulin signalling in co-cultured adipocytes. RBP4 levels have been discovered to be higher in SCH patients in recent research .Despite a well-known association of thyroid dysfunction with T2DM, no more known studies have been conducted in Egypt to investigate the effect of such relationship on CVD risk of T2DM/or hypothyroidism patients. Therefore, our objective in this study was to identify a diagnostic biomarker of retinol binding protein-4 (RBP4) as a diagnostic biomarker of thyroid dysfunction on the CVD risk of Egyptian T2DM patients.This study intended to assess serum RBP4 levels in type 2 diabetic patients with hypothyroidism and CVD, 96 Egyptian individuals were enrolled in the study and divided into 8 groups, each group consisted of 12 patients to study the association between T2DM, hypothyroidism, CVD and RBP4. Regarding RBP4 in the studied groups, our investigations revealed that the highest levels of RBP4 were observed in T2DM patients with both hypothyroidism and CVD. Mean levels of RBP4 were significantly increased in this group compared to controls, T2DM patients, hypothyroidism patients, or CVD patients. Also, T2DM patients with either hypothyroidism or CVD showed significantly increased levels of RBP4 in comparison with controls. our data revealed that RBP4 had an AUC of 0.850 (P=0.003) in this group, making it a strong diagnostic power of the concomitant diseases. When an RBP4 cut-off of >872.5 pg/ml was applied to detect the disease, it yielded a sensitivity of 40%, specificity of 100%, and overall 95% CI 0.291 to 0.859. This exploratory work highlighted RBP4 as a promising candidate for the design of diagnostically accurate biomarkers in the concomitant diseases of type 2 diabetes mellitus, hypothyroidism and cardiovascular disease.