title: Urinary TNF-α and NGAL are correlated with the progression of nephropathy in patients with type 2 diabetes.
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.
authors.affiliation: Department of Endocrinology, Shanghai TCM-Integrated Hospital, Shanghai 200082, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
authors.forename: Yaqing
authors.initials: Y
authors.lastname: Ding
authors.forename: Chunling
authors.initials: C
authors.lastname: Zhu
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Shao
authors.forename: Xin
authors.initials: X
authors.lastname: Xie
authors.forename: Kan
authors.initials: K
authors.lastname: Lu
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
keywords: diabetic nephropathy; neutrophil gelatinase-associated lipocalin; tumor necrosis factor-α