The Levels And Significance Of Inflammation-related Factors In The Progression Of Diabetic Nephropathy

objective：To study the levels and clinical significance of serum high sensitivityC-reactive protein（hs-CRP）、interleukin-6（IL-6）、tumor necrosis factor-α（TNF-α）and urinary Transforming growth factor-β（TGF-β）、monocytechemoattractant protein-l （MCP-1）、connective tissue growth factor（CTGF）in patients witll type2Diabetic Nephropathy(DN)Methods：one Hundred and thirty-eight patients witll type2Diabetic (Male70，Female68were recruited in the study．T2DMs were further divided into4groups according to their AER，that was patients with Normal AER(n=46，Male21and Female25)，patients with Microalbuminuria(n=32，Male17and Female15)and patients with proteinuria(n=28，Male17and Female11)．End-stage renal disease(n=32，Male15and Female17).Thirty healthyChinese volunteers were recruited as normal controls．Study exclusioncriteria were acute or chronic fection，primary and secondary kidneydisease，etc．Concentrations of hs-CRP、IL-6、TNF-αin serum and TGF-β、MCP-1、CTGF in Urine were measured by ELISA．And the clinical andlaboratory data of the patients were collected．All statistical analyses wereperformed with SPSS16.0statistical software.Results:1, serum hs-CRP levels in DN groups were significantly higher than the healthy control group comparison between groups was statisticallysignificant (p <0.05). Correlation analysis showed that the level of hs-CRPwas positively correlated with AER, was negatively correlated with GFR.2, serum IL-6, serum TNF-α levels and urine of TGF-beta level in DNgroups were higher (p <0.05), macroalbuminuria of microalbuminuriaincreased significantly. Correlation analysis showed that IL-6, TNF-alphaand TGF-β levels and AER was positively correlated.3, urinary MCP-1levels of each of the DN were higher (p <0.05), thenormoalbuminuria period and microalbuminuria were no significantdifferences (p>0.05); macroalbuminuria of after urinary MCP-1levelsincreased significantly; correlation analysis showed that urinary MCP-1level of GFR was negatively correlated.4, Urinary CTGF levels were higher than in the DN stages of the control (p<0.05) peak in microalbuminuria.Conclusions：Inflammatory factors, hs-CRP and IL-6, TNF-alpha, TGF-beta,MCP-1and CTGF are involved in the occurrence and development of theDN; IL-6, TNF-alpha and TGF-beta may be associated with proteinuriadevelopment; of MCP-1and DN late progression to kidney failure related;of CTGF may be involved in the DN early progress related to theoccurrence of microalbuminuria.