Department of Internal Medicine, Osaka North Postal Services Agency Hospital, Osaka, Japan.
Diabetes Res Clin Pract. 2013 Feb;99(2):145-50. doi: 10.1016/j.diabres.2012.11.002. Epub 2013 Jan 30.
Chronic low-grade inflammation and/or obesity are suggested to induce chronic kidney disease (CKD) in patients with type 2 diabetes. This cross-sectional study was performed to investigate the relationship between inflammatory biomarkers and CKD in non-obese patients with type 2 diabetes.
106 non-obese Japanese patients with type 2 diabetes were recruited for the measurement of GFR, TNF, HMW adiponectin, leptin, hsCRP and some variables including urinary albumin. BMI, serum creatinine, and urinary albumin levels were 22.2 ± 0.2 kg/m(2) (17.1-24.9 kg/m(2)), 0.76 ± 0.02 mg/dl (0.39-1.38 mg/dl), 40.4 ± 4.3mg/gCr (1.6-195.0mg/gCr), respectively. They were stratified into two groups based on the value of eGFR: low eGFR (eGFR<60 ml/min/1.73 m(2)) and normal eGFR (eGFR>60 ml/min/1.73 m(2)). Logistic regression analysis was used for statistical analysis.
Whereas univariate logistic regression analysis showed that gender, diabetes duration, triglyceride, HDL cholesterol, uric acid, urinary albumin, and soluble TNF receptors (sTNF-R1, sTNF-R2) are associated with the development of stage 3 CKD, multivariate logistic regression analysis revealed that sTNF-R2 (Odds ratio 1.003, 95% confidence interval 1.000 to 1.005, P=0.030) showed significant associations with the development of stage 3 CKD.
Circulating TNF receptor 2 is an independent risk factor for CKD in non-obese Japanese patients with type 2 diabetes.
慢性低度炎症和/或肥胖被认为会在 2 型糖尿病患者中引发慢性肾病（CKD）。本横断面研究旨在探讨非肥胖 2 型糖尿病患者中炎症生物标志物与 CKD 之间的关系。
招募了 106 名非肥胖的日本 2 型糖尿病患者，以测量 GFR、TNF、高分子量脂联素、瘦素、hsCRP 和一些变量，包括尿白蛋白。BMI、血清肌酐和尿白蛋白水平分别为 22.2±0.2kg/m²（17.1-24.9kg/m²）、0.76±0.02mg/dl（0.39-1.38mg/dl）、40.4±4.3mg/gCr（1.6-195.0mg/gCr）。根据 eGFR 值将他们分为两组：低 eGFR（eGFR<60ml/min/1.73m²）和正常 eGFR（eGFR>60ml/min/1.73m²）。使用逻辑回归分析进行统计分析。
单变量逻辑回归分析显示，性别、糖尿病病程、甘油三酯、HDL 胆固醇、尿酸、尿白蛋白和可溶性 TNF 受体（sTNF-R1、sTNF-R2）与 3 期 CKD 的发生有关，而多变量逻辑回归分析显示，sTNF-R2（比值比 1.003，95%置信区间 1.000 至 1.005，P=0.030）与 3 期 CKD 的发生有显著关联。
循环 TNF 受体 2 是 2 型糖尿病非肥胖日本患者 CKD 的独立危险因素。
