The Correlation Research Of Plasma Omentin And TNF-α Levels With Type2Diabetic Nephropathy

Objective:To investigate the levels of plasma omentin, tumor necrosis factor-alpha(TNF-α)and related clinical parameters in type2diabetes and normalsubjects.The relationship between plasma omentin,TNF-α and related clinicalcharacteristic was evaluated,and their variation and tendency in different stageof diabetic nephropathy were analyzed.This research will help to discussedthe possibly pathogenic mechanism of omentin and TNF-α on diabeticnephropathy and provide theoretical basis on prevention and treatment of type2diabetic nephropathy.Methods:Seventy patients with T2DM(DM group) were divided into threegroups according to the24-hour urinary albumin excretion rate (UAER):clinical proteinuria group（CA group,24cases）, microalbuminuria group（MA group,21cases）and normal albuminuria group（NA group,25cases）compared with thirty normal subjects (NC group). The plasma omentin andTNF-α levels were detected by enzyme-linked immunosorbent (ELISA) andrelevent clinical features were collected simultaneously in all subjects. Thediscrepancies of indexes among different groups were compared,thecorrelation between omentin,TNF-α and previous clinical indicators wereanlyzed.Influence factors of omentin, TNF-α were determinated throughMutliple stepwise regression anlysis. Result:1.The levels of waist hip ratio (WHR), fasting blood glucose(FBG),fasting insulin (FINS), HOMA index (HOMA-IR), HbA1c, Scr, BUN, LDL-cin T2DM were obviously higher compared with control group (P<0.05),andthe levels of HDLC,eGFR were significantly lower contrast with controlgroup (P<0.05).The levels of plasma omentin in T2DM was less than controlgroup(0.658±0.095ug/ml vs0.729±0.186ug/ml, P<0.01), on the contrary thelevels of plasma TNF-α in T2DM was more than control group(8.350±1.044pg/ml vs6.903±0.265pg/ml, P<0.01).2.The levels of Scr and HbA1c in each group was CA group>MAgroup>NA group,the levels of eGFR was CA group <MA group <NAgroup,which showed statistically difference among groups (P<0.05).Thelevels of plasma omentin was CA group<MA group<NA group（0.598±0.139ug/ml vs0.675±0.041ug/ml vs0.701±0.012ug/ml, P<0.05）,thelevels of plasma TNF-α was CA group>MA group> NA group（9.414±0.374pg/ml vs8.176±1.104pg/ml vs7.475±0.167pg/ml, P<0.05)which were statistically different among groups.3.Correlation analysis indicated plasma omentin was positivelycorrelated with eGFR and HDL-c (P<0.05),while negatively correlated withWHR, FINS, HOMAIR, Scr, BUN, UA, BMI, UAER, HbA1c (P<0.05).TNF-α was positively correlated with WHR, FINS, HOMAIR, Scr,LDL-c,UAER,BUN, HbA1c (P<0.05),while negatively correlated with eGFR(P<0.01). Plasma omentin was negatively correlated with TNF-α(r=-0.338，P<0.01).4.WHR(t=-4.157),eGFR(t=3.970)were independent influencedfactors for omentin(P<0.01,respectively) in a way of mutiple stepwiseregression model, meanwihle eGFR (t=-2.359),LDLC (t=2.003), HbA1c (t=4.578,)were independent variables for TNF-α(P<0.05, respectively).Conclusion:1. The plasma omentin levels in patients with the type2diabetes werelower than that of normal control group obviously while the plama TNF-αlevels were higher compared with control group respectively，the degree ofmodification was in correspond with development of proteinuria and severityof type2diabetic nephropathy.2. Omentin was positively correlated with HDL-c,whereas TNF-α wasnegatively correlated with LDL-c.It suggested that plasma omentin andTNF-α may be involved in the abnormal lipid metabolism in type2diabeticnephropathy.3. Omentin was negatively correlated with TNF-α, it seems they mightparticipate in the mechanism of type2diabetic nephropathy with kidneydamage together.