Abstract
Background: Diabetic nephropathy (DN) is the main cause of morbidity and mortality in young adults with type 1 diabetes mellitus (T1DM). The accuracy of albuminuria has been frequently questioned as a predictor and prognosticator of renal injury. Therefore, new urinary markers were investigated for the early detection of DN. Objectives: To assess the potential value of urinary interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) as early markers for detection of DN in children and adolescents with T1DM. Method: This case-control study was conducted on 50 children and adolescents with T1DM, aged ≤ 18 years. Patients were classified according to their albumin/creatinine ratio (ACR) into two groups; normo-albuminuric and albuminuric group, together with 25 age and sex-matched healthy controls. ACR, urinary IL-6 and TNF-α levels were assayed for the patients and controls. Results: Urinary interleukin-6/creatinine (IL-6/Cr) ratio of albuminuric patients was significantly higher compared to normo-albuminuric patients or controls. Urinary IL-6/Cr ratio ≥ 0.24 pg/mg showed a significant cutoff value to detect albuminuria with 72% sensitivity and 52% specificity (p= 0.04). While, we did not observe different urinary tumour necrosis factor-alpha/creatinine (TNF-α/Cr) ratio in the studied groups, or between albuminuric and normo-albuminuric patients or controls Conclusions: Urinary IL-6/Cr ratio seems to be a promising new marker for early detection of DN in patients with T1DM, while urinary TNF-α /Cr ratio showed no significant difference between diabetic patients and controls. Sri Lanka Journal of Child Health, 2020; 49(3): 269-275
Highlights
Complications of diabetes mellitus (DM) include diabetic nephropathy (DN), retinopathy, and cardiovascular disease[1]
Urinary interleukin-6/creatinine (IL-6/Cr) ratio of albuminuric patients was significantly higher compared to normo-albuminuric patients or controls
Urinary IL-6/Cr ratio ≥0.24pg/mg was a significant cutoff value to detect albuminuria with 72% sensitivity and 52% specificity (p=0.04)
Summary
Complications of diabetes mellitus (DM) include diabetic nephropathy (DN), retinopathy, and cardiovascular disease[1]. DN is the most serious microvascular complication and is the leading cause of chronic kidney disease, which frequently leads to end stage renal disease[2]. Urinary albumin levels may merely reflect an initial reversible stage of renal damage[3]. Detection of new predictive markers to use with microalbuminuria during the early stages of diabetic kidney disease would provide a chance of preventing or delaying the onset of irreversible consequences through prohibitive therapeutic interventions[4]. Hyperglycaemia can promote the expression of some pro-inflammatory cytokines, like interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), which lead to a chronic subclinical inflammatory state in DM5. New urinary markers were investigated for the early detection of DN
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
