Urinary TNF‑α and NGAL are correlated with the progression of nephropathy in patients with type 2 diabetes

Wu,Jian; Ding,Yaqing; Zhu,Chunling; Shao,Xiaohong; Xie,Xin; Lu,Kan; Wang,Rui

doi:10.3892/etm.2013.1315

Urinary TNF‑α and NGAL are correlated with the progression of nephropathy in patients with type 2 diabetes

Authors:
- Jian Wu
- Yaqing Ding
- Chunling Zhu
- Xiaohong Shao
- Xin Xie
- Kan Lu
- Rui Wang
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Affiliations: Department of Endocrinology, Shanghai TCM‑Integrated Hospital, Shanghai 200082, P.R. China
Published online on: September 26, 2013 https://doi.org/10.3892/etm.2013.1315
Pages: 1482-1488

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Abstract

The aim of this study was to investigate the correlation of the proinflammatory marker tumor necrosis factor‑α (TNF‑α) and the tubular marker neutrophil gelatinase‑associated lipocalin (NGAL) with the progression of the early stage of type 2 diabetic nephropathy (DN). Baseline levels of urinary TNF‑α and NGAL were measured in 63 non‑diabetic controls and 201 patients with type 2 diabetes and different albuminuria statuses. The patients with diabetes (n=125) with normo‑ or microalbuminuria were subsequently followed‑up for 28 (25‑32) months, with routine measurements of creatinine and urinary albumin excretion (UAE). It was observed that baseline levels of urinary TNF‑α and NGAL were significantly elevated and correlated with the severity of albuminuria in patients with diabetes. During the follow‑up, the urinary levels of TNF‑α and NGAL were observed to be significantly correlated with a rapid decline in the estimated glomerular filtration rate (eGFR). Following adjustment for other progression promoters, including albuminuria, TNF‑α remained a significant predictor of eGFR decline. These results suggest that inflammation is important in the pathogenesis of DN and indicate that TNF‑α may be used as an independent predictor for the progression of DN at the early stage.

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