title: TNF-α and microalbuminuria in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Recent evidence suggests that chronic subclinical inflammation plays a key role in the pathogenesis and progression of diabetic nephropathy. Aim of the present study was to investigate possible correlation between the presence and degree of microalbuminuria and markers of inflammation in patients with type 2 diabetes mellitus (DM).
  
  
  METHODS
  Eighty patients were enrolled and clinical and laboratory data were recorded. Albumin-creatinine ratio (ACR) was calculated in first-morning urine samples. Serum and urinary tumor necrosis factor-α (TNF-α) levels were determined by ELISA.
  
  
  RESULTS
  Forty-five patients had normoalbuminuria, 33 microalbuminuria, and 2 macroalbuminuria. Patients with microalbuminuria were older, with higher glycosylated hemoglobin levels (HbA1c) and they more frequently had diabetic retinopathy, neuropathy, and cardiovascular disease and were on treatment with angiotensin converting enzyme inhibitors (ACEi) and/or angiotensin receptor blockers (ARBs). ACR was significantly correlated with the presence of cardiovascular disease, hypertension, and HbA1c levels and the administration of clopidogrel and ACEi or ARBs. ACR was not correlated with C-reactive protein, fibrinogen, or serum TNF-α levels but had a strong correlation with urinary TNF-α levels.
  
  
  CONCLUSIONS
  In patients with type 2 DM, urinary, but not serum, TNF-α levels are associated with the presence and severity of microalbuminuria.
authors.affiliation: Department of Nephrology, "Hippokratio" General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 546 42 Thessaloniki, Greece.
authors.forename: I-Th
authors.initials: IT
authors.lastname: Lampropoulou
authors.affiliation: Department of Nephrology, "Hippokratio" General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 546 42 Thessaloniki, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Stangou
authors.affiliation: Department of Nephrology, "Hippokratio" General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 546 42 Thessaloniki, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Papagianni
authors.affiliation: 1st Propedeutic Department of Internal Medicine, Diabetes Center, "AHEPA" General Hospital, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Didangelos
authors.affiliation: 1st Propedeutic Department of Internal Medicine, Diabetes Center, "AHEPA" General Hospital, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece.
authors.forename: F
authors.initials: F
authors.lastname: Iliadis
authors.affiliation: Department of Nephrology, "Hippokratio" General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 546 42 Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Efstratiadis
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000652:urine*; D016482:Urinalysis
chemical_list: D015415:Biomarkers; D003404:Creatinine; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; C517652:hemoglobin A1c protein, human