Relationship between serum C-reactive protein,interleukin-6, tumor necrosis factor-α and diabetic nephropathy

Objective To study the changes of C-reactive protein,interleukin-6(IL-6),tumor necrosis factor-α(IFN-α),white blood cells(WBC) in type 2 diabetic nephropathy.Methods One hundred patients with type 2 diabetes (1999 WHO diagnostic standards) were selected for this study.The patients were divided into three groups according to urinary albumin excretion rate(UAER): 40 patients with normal UAER were DM group,33 patients with microalbuminuria were DN1 group and 27 patients with clinical protein uria were DN2 group.Thirty healthy subjects were used as control group.The serum levels of C-reactive protein (CRP),IL-6,TNF-α were measured with chemiluminescent immunoassay.Results The serum levels of CRP ( 5.80± 3.20) mg/L,IL-6 ( 10.0± 4.5) ng/L,TNF-α( 16.2± 8.5) ng/L in DM were significantly higher than those of control group ( 2.90± 1.80) mg/L,( 7.3± 2.0) ng/L,( 13.0± 4.1) ng/L,respectively(P 0.05).In DN1 and DN2 group,the serum levels of CRP,IL-6,TNF-α and WBC were significantly different in comparison with those of control group (P 0.05 or P 0.01) and DM group (P 0.05).The serum level of CRP in DN2 ( 12.50± 8.60) mg/L was higher than that of DN1 ( 7.20± 5.20) mg/L(P 0.05).Significantly correlations were found among serum CRP and IL-6 with Tc(r= 0.510,P 0.01;r= 0.271,P 0.01),serum TNF-α and WBC with BMI (r= 0.236,P 0.01;r= 0.254,P 0.01),serum IL-6 with HbA 1c(r= 0.351,P 0.01).Conclusion The serum levels of inflammatory factors increased with urinary albumin in type 2 diabetic patients.Serum levels of CRP,IL-6,TNF-α and WBC in type 2 diabetic patients may be reliable clinical markers for assessing the severity and prognosis of diabetic nephropathy.