Clinical Significance of Urinary Monocyte Chemoattractant Protein-1 (uMCP-1) and TNF-Alfa in Indian Type 2 Diabetic Patients at Different Stages of Diabetic Nephropathy

Abstract

Introduction: TNF alfa and Monocyte Chemoattractant Protein-1 (MCP-1) are inflammatory markers upregulated in diabetic nephropathy. This study aims to find the levels of urinary MCP-1 (uMCP-1) and serum TNF alfa levels at different stages of diabetic nephropathy and to see its correlation with UACR(Urinary Albumin Cdeatinine Ratio) in Indian type2 diabetic subjects Methods: Consecutive Patients of Type 2 Diabetes Mellitus (DM) with or without microalbuminuria attending SCB MEDICAL COLLEGE and HOSPITAL Medical OPDs in one year were recruited in this study.Patients were subjected to blood and urine investigations. Groups are Group 1 (control), Group 2 (diabetes with normoalbuminuria), Group 3 (diabetes with microalbuminuria), Group 4 (diabetes with macroalbuminuria). Diabetic Nephropathy were classified according to KIGDO staging. Anthropometric and biochemical details were recorded for all the subjects.UACR calculated by the formula which has been approved by National Kidney Disease Education Program. Urinary MCP-1 and TNF alfa levels were measured by using ELISA. Results: S.urea creatinine, Total cholesterol, TG, LDL, UACR, S.TNF alfa, UMCP1 levels are significantly high in diabetes with macroalbuminuria group (p = 0.01, 0.001, 0.013, 0.01, <0.01, <0.01, <0.01, 0.01 respectively). UACR is positively correlated with umcp1 (r= 0.413 , P=<0.01) and S.TNF alfa (r= 0.218, p=0.008). Increasing uMCP-1, S.TNF alfa levels with the progression of diabetic nephropathy indicating the extent of renal tubular and glomerular damage (p value 0.015,0.008 respectively.) Funding Statement: The authors stated: No funding has been allocated to this research work. Declaration of Interests: The authors declared: There is no conflict of interest. Ethics Approval Statement: This cross-sectional study has been approved by Ethical committee