title: Changes in the inflammatory markers with advancing stages of diabetic nephropathy and the role of pentraxin-3.
abstract: BACKGROUND
  Immunological and inflammatory mechanisms have been shown to have role in both the development and progression of diabetic nephropathy (DNP). There is need for more specific markers for inflammation as the ones commonly used are influenced by many factors. Pentraxin-3 (PTX-3) seems to be a potential candidate. We aimed in our study to evaluate the changes of PTX-3 levels in different stages of DNP and its relationship with other inflammatory markers.
  
  
  METHODS
  This is a cross sectional study in which patients with DNP at different stages were involved. Patient were divided into three groups according to estimated glomerular filtration rate (eGFR), microalbuminuria and proteinuria levels: Group-1: eGFR >60 mL/min and microalbuminuria, Group-2: eGFR >60 mL/min and macroalbuminuria, Group-3: eGFR <60 mL/min and macroalbuminuria. Besides the routine biochemical parameters, levels of PTX-3, high sensitivity C-reactive protein (hsCRP), interleukin (IL)-1 and tumor necrosis factor (TNF)-α was measured. Groups were compared with each other regarding the study parameters and correlation of PTX-3 with other markers was evaluated.
  
  
  RESULTS
  The mean PTX-3 level in Group-2 (0.94 ± 0.26 ng/mL) and -3 (1.35 ± 1.55 ng/mL) were higher than in Group-1 (0.81 ± 0.25 ng/mL) (p = 0.009 and p = 0.012). There was a significant correlation of PTX-3 with proteinuria (r = 0.266, p = 0.016), microalbuminuria (r = 0.304, p = 0.014) and hypoalbuminemia (r = 0.197, p = 0.043). PTX-3 was not correlated with other markers of inflammation (IL-1, TNF-α and hsCRP) and diabetic metabolic parameters (hbA1c, C-peptide, insulin and HOMA-IR). PTX-3, IL-1 and TNF-α levels increased with the advancing stage of DNP while hsCRP level did not change.
  
  
  CONCLUSIONS
  PTX-3 that increases similar to other markers of inflammation (IL-1, TNF-α) is a better inflammatory marker than hsCRP. Furthermore, there is a relationship between PTX-3 and proteinuria independent from eGFR.
authors.affiliation: a Department of Nephrology , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Sami
authors.initials: S
authors.lastname: Uzun
authors.affiliation: b Department of Internal Medicine , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Muge
authors.initials: M
authors.lastname: Ozari
authors.affiliation: c Department of Nephrology , Medical Faculty of Bezmialem Vakif University , Istanbul , Turkey ;
authors.forename: Meltem
authors.initials: M
authors.lastname: Gursu
authors.affiliation: a Department of Nephrology , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Serhat
authors.initials: S
authors.lastname: Karadag
authors.affiliation: a Department of Nephrology , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Ahmet
authors.initials: A
authors.lastname: Behlul
authors.affiliation: d Department of Biochemistry , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Soner
authors.initials: S
authors.lastname: Sari
authors.affiliation: d Department of Biochemistry , Haseki Training and Research Hospital , Istanbul , Turkey.
authors.forename: Macit
authors.initials: M
authors.lastname: Koldas
authors.affiliation: b Department of Internal Medicine , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Secil
authors.initials: S
authors.lastname: Demir
authors.affiliation: b Department of Internal Medicine , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Karaali
authors.affiliation: a Department of Nephrology , Haseki Training and Research Hospital , Istanbul , Turkey ;
authors.forename: Savas
authors.initials: S
authors.lastname: Ozturk
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications; D015415:Biomarkers; D002097:C-Reactive Protein / Q000737:chemistry*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000097:blood; D007375:Interleukin-1 / Q000097:blood*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D000683:Serum Amyloid P-Component / Q000737:chemistry*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D014421:Turkey; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D007375:Interleukin-1; D000683:Serum Amyloid P-Component; D014409:Tumor Necrosis Factor-alpha; D000099153:Pentraxins
keywords: C-reactive protein; cytokines; diabetic nephropathy; inflammation; pentraxin-3; proteinuria