The Changes Of Inflammatory Cytokines And Its Clinical Significance In Diabetic Nephropathy Patients

Objective To measure levels of the serum TNF-? IL-6 Cystatin C in diabetic nephritis patients and analyze its clinical significance in diabetic kidney disease;explore the risk factors of diabetic kidney disease.Methods(1)88 diabetic mellitus patients were randomly selected,with 58 cases of men,30 cases of women.All cases were divided into three groups,21 cas es were divided into normal albuminuria group,with 15 cases of men,6 cases of women;35 cases were divided into DKD microalbuminurial group,with 24 cases of men,11 cases of women;32 cases were divided into DKD clinical proteinurial group,with 19 cases of men,13 cases of women.(2)With Fasting blood of all cases,Hcy,Fasting plasma glucose(FPG),Cys C,serum urea nitro gen(BUN),hemoglobin A(Hb A1c),serum creatinine(SCr),serum uric acid(SU A),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)were measured,and 24-hou r urinary albumin excretory rate were examined.Some serum were measured l evels of serum interleukin 6 and tumor necrosis factor with Elisa.the clinical data such as gender age were collected.(3)Data between the groups in compa rison,Multivariable linear regression models were used to examine correlations between Cys C and the inflammatory biomarkers and other datas for important DKD risk factors.Result(1)In DKD microalbuminurial group,the levels of Cys C were higher co mpared to DM normal albuminurial group,while lower compared to DKD clinical proteinurial group(P<0.05),statistic differences were significant.(2)In DKD microalbuminuria group,the levels of Hcy were higher compared to DM norm al albuminurial group,while lower compared to DKD clinical proteinurial group(P<0.05),statistic differences were significant.(3)In DKD group,the TNF-? were lower than in DM normal albuminurial group,statistic differences were matchable.(4)In DKD group,the IL-6 were lower than in DM normal albuminurial group,statistic differences were matchable.(5)There were no significant difference in levels of year,gender,Hb A1 c,TG,TC,HDL-C,LDL-C among grou ps.(6)Multivariable linear regression showed that serum creatinine,serum uric acid were positively correlated with Cys C as serumurea nitrogen,serum creati nine,serumuric acid were independents(P<0.05).(7)Multivariable linear regressi on showed that age,Hcy and proteinuria were positively correlated with Cys C as gender,age,Hcy,TNF-?,IL-6,proteinuria,glycosylated hemoglobin total plasmacholesterol trilyceride were independents(P<0.05).Conclution Cys C is the detection biomarker of early DKD.These findings indicate that serum TNF-? and IL-6 arn't associated with the onset of diabetic nep hropathy,but age,Hcy and proteinuria have obvious correlation with the onset of diabetic nephropathy.