Study of Neutrophil–Lymphocyte Ratio, Interleukin-6 (IL-6) and Tumor Necrosis Factor-Alpha (TNF-α) in Type 2 Diabetes with Diabetic Nephropathy

Abstract

Abstract Background Diabetic kidney disease is defined by characteristic structural and functional changes. The predominant structural changes include mesangial expansion, glomerular basement membrane thickening, podocyte injury, and, ultimately, glomerular sclerosis. The major clinical manifestations of diabetic nephropathy are albuminuria, hematuria (less often), and, in many patients, progressive chronic kidney disease, which can be slowed with optimal therapy. Objective to assess the Neutrophil-lymphocyte Ratio, Interleukin- 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in Type 2 Diabetes with Diabetic Nephropathy. Patients and Methods In Our study We collect 90 subjects with their ages ranging from 35-70, selected from Internal Medicine and Endocrinology outpatient clinics and the inpatient department at Ain Shams University Hospitals. Results As regards NLR, there were statistically significant and direct correlations between NLR and IL6, TNF, serum BUN, serum creatinine and albumin to creatinine ratio, while significant and indirect correlation with EGFR. As regards IL6, there were statistically significant and direct correlations between IL6 and TNF, serum BUN, serum creatinine and albumin to creatinine ratio, while significant and indirect correlation with BMI and EGFR. As regards TNF, there were statistically significant and direct correlations between TNF and serum BUN and albumin to creatinine ratio. There is no statistical difference between the studied groups as regard sex, age, BMI, SBP, DBP. Conclusion The current study could find that NLR, IL-6 and TNF-α were significantly associated with albuminuria in Type 2 Diabetic patients with DN and that they can be used as evident biomarkers in assessing the progression of deteriorating renal function and different stages of renal disease in patients with DN.