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Subject Area

Cardiology and Vascular Medicine

Article Type

Original Study

Abstract

Objectives To study the role of tumor necrosis factor alpha (TNF-α) in type 2 diabetic nephropathy (DN). Background DN, a long-term major microvascular complication of uncontrolled hyperglycemia, affects a large population worldwide. It is considered the driving cause of end-stage kidney disease. TNF-α is a proinflammatory cytokine and plays an important role in the pathogenesis and clinical outcome of DN. Patients and methods The present case–control study was conducted on three groups: group I included 20 healthy controls, group II [diabetes mellitus (DM)] included 38 patients with type 2 DM without nephropathy, and group III comprised diabetes with chronic kidney disease (DM-CKD) and included 40 patients with type 2 DM with nephropathy. TNF-α level was determined using enzyme-linked immunosorbent assay. Routine chemical tests were done using chemistry autoanalyzer, and glycated hemoglobin was measured using ion-exchange resin chromatography. Correlations were tested by Pearson's correlation analysis. Logistic regression was used to detect the most independent/affecting factor for development of the DN. Results Serum level of TNF-α in DM group was significantly higher than controls (P < 0.001); in addition, the level in DM-CKD was significantly higher than controls and DM (P < 0.001). Moreover, there was a significant positive correlation between serum levels of TNF-α and fasting blood glucose, creatinine, total cholesterol, low-density lipoprotein-cholesterol, glycated hemoglobin, and microalbumin/creatinine ratio among DM-CKD group (r = 0.042, <0.001, <0.001, <0.001, 0.027, and 0.043, respectively). Conclusion Serum TNF-α was significantly increased in patients with DM and DM-CKD but was higher in patients with DM-CKD, which designates that TNF-α can participate in progression of DM to DN and might play an important role in mediating DN.

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