title: Association between serum soluble TNFα receptors and renal dysfunction in type 2 diabetic patients without proteinuria.
abstract: OBJECTIVE
  The aim of our study was to investigate whether serum levels of soluble tumor necrosis factor α receptor (sTNFR) 1 and 2 are markers for renal dysfunction in type 2 diabetic patients without overt proteinuria.
  
  
  METHODS
  Japanese type 2 diabetic patients without overt proteinuria (n = 168) enrolled in the prospective observational follow-up study in 2001 were retrospectively analyzed. At baseline, the serum levels of sTNFR1 and sTNFR2 were measured by sandwich ELISA. The associations between these markers and change in estimated glomerular filtration rate (eGFR) after 5 years were evaluated.
  
  
  RESULTS
  The levels of sTNFR1 and sTNFR2 closely correlated. At baseline, sTNFR1 and sTNFR2 associated inversely with eGFR. After 5 years, patients with high level of both sTNFR1 and sTNFR2 showed a greater decline in eGFR (-13.8 ± 15.5% versus -8.5 ± 11.8%, P = 0.027) and a 4-fold higher risk for a GFR decline of ≥ 25% than those with high level of only one receptor or low level of both receptors. These associations were enhanced in diabetic women.
  
  
  CONCLUSIONS
  The higher levels of sTNFR1 and sTNFR2 were associated with a greater decline in eGFR in type 2 diabetic patients without proteinuria, especially in diabetic women.
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Seta, Otsu, Shiga 520-2192, Japan.
authors.forename: Itsuko
authors.initials: I
authors.lastname: Miyazawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Araki
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Obata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshizaki
authors.forename: Katsutaro
authors.initials: K
authors.lastname: Morino
authors.forename: Aya
authors.initials: A
authors.lastname: Kadota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ugi
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kawai
authors.forename: Takashi
authors.initials: T
authors.lastname: Uzu
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nishio
authors.forename: Daisuke
authors.initials: D
authors.lastname: Koya
authors.forename: Masakazu
authors.initials: M
authors.lastname: Haneda
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kashiwagi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000473:pathology*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood*; D012737:Sex Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha