Human Tumor Necrosis Factor-α as a Diagnostic Marker for Chronic Diabetic Nephropathy

Abstract

Background: diabetic nephropathy (DN) is a chronic main microvascular consequence of untreated hyperglycemia, affects a significant portion of the population. It's thought to be the main factor causing end-stage kidney disease. TNF-α is involved in the development and course of disease in DN. Aim: This study aimed to evaluate plasma TNF-α as a new diagnostic marker for early DN. Patients and Methods: This study included 125 Egyptian subjects attending the out Patients Clinic of the Department of Internal Medicine, 10Th of Ramadan city Health Insurance Hospital and divided as follow:- Control group , Study groups( patient with diabetic mellitus (DM),DN, DN and other complications). Control& study group were subjected to measurement of   glycosylated hemoglobin (HbA1C), creatinine, total cholesterol, triglycerides, F.B.G, GFR  ,HDL, LDL, ALT, AST, total protein, albumin, globulin, A/G ratio, HDL, LDL, ACR,TNF-α. Results: results showed that plasma TNF-α was positive and significantly correlated with BMI, duration of DM, F.B.G, HbAIC, CR, GFR, CHOL, HDL, LDL, AST, A/G ratio, Meanwhile, plasma TNF-α was negatively correlated with ACR, TG, ALT, ALB, TP and GLB. At cut-off level ≥83.5, TNF-α had 96.7% sensitivity and 79.7% specificity for diagnosing diabetic nephropathy. Conclusion: The study found that patients in study group had considerably higher plasma levels of TNF-α. This suggests that TNF-α May be used as a markers for predicting chronic DN in patients with type 2 diabetes.