Study of Serum Tumor Necrosis Factor Alpha and Interleukin 6 in Type 2 Diabetic Patients with Albuminuria

Background: Chronic kidney disease (CKD) is one of the major complications of type 2 diabetes and is the leading cause of end stage renal disease (ESRD). There are Growing evidences indicating that chronic low-grade inflammatory response is a recognized factor in the pathogenesis of development and progression of diabetic renal injury. The aim of this study was to analyze the relationship between inflammatory markers tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) with urinary albumin excretion (UAE) as a marker of renal injury. Methods: A total of 73 type 2 diabetic patients were divided into three groups according to urinary albumin excretion, normoalbuminuria, microalbuminuria and macroalbuminuria In addition, 10 apparently healthy subjects were included as control group. TNF-alpha, IL-6, Glycated hemoglobin (HbA1c) and creatinine were measured in all population. Urinary albumin excretion was measured by morning spot sample albumin/creatinine ratio (ACR). Results: Levels of TNF-alpha and IL-6 were found to differ significantly among studied groups. Both markers showed significant positive correlation with duration of diabetes, Albumin creatinine ratio and glycated hemoglobin and showed significant negative correlation with estimated glomerular filtration rate (eGFR), however TNF-alpha showed a better correlation with these variables when compared with IL-6. Stepwise regression analysis demonstrated that TNF-alpha is the independent predictors for ACR in total population with adjusted R-2 0.512 and P value less than 0.01. Conclusion: TNF-alpha and IL-6 are higher in type 2 diabetic patients with albuminuria and correlate well with the severity of albuminuria, however TNF-alpha was found to be a predictor of ACR suggesting the possible role of TNF-alpha in pathogenesis and progression of renal affection in type 2 diabetic patients. [Ahmed Zahran, Enas S. Essaand Waleed F. Abd ElazeemStudy of Serum Tumor Necrosis Factor Alpha and Interleukin 6 in Type 2 Diabetic Patients with Albuminuria. Life Science Journal 2012; 9(1):877-882]. (ISSN:1097-8135). http://www.lifesciencesite.com. 128