All India Institute of Medical Sciences, Bhubaneswar.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
In India, diabetic nephropathy (DN) is the most common cause of chronic kidney disease. Timely detection of microalbuminuria and appropriate intervention can reverse or arrest the progress of nephropathy. The pathogenesis of diabetic nephropathy has revealed that during the early onset of kidney involvement in diabetics, inflammation and fibrosis progress from tubular to glomerular damage. This study was designed to elucidate the association of chemokines, Omentin 1, and interleukin 6 (IL-6) with microalbuminuria.
Settings and Design: This cross-sectional observational study was conducted as a collaborated study in the Departments of General Medicine and Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, India, during 2019-2020.
Our study group comprised 116 diabetes mellitus patients. They were grouped into two, each of 58 on the basis of their urine albumin levels; Group 1 (controls) had UACR < 30 μg/mg, eGFR> 90ml/ min and Group 2 (cases) had UACR ≥ 30 μg/mg and < 300 μg/mg, eGFR>60ml/min and < 90ml/min. Serum omentin 1 and IL-6, creatinine, glycated haemoglobin (HbA1c), fasting (FBS) and postprandial blood sugar (PPBS), lipid profile, total protein, albumin, and fasting insulin, HOMA-IR were studied.
Our study showed that Omentin 1 levels were decreased, and IL-6 levels were increased in the DN group compared to the T2DM without DN. The risk estimates calculated revealed that diabetes mellitus patients having an IL-6: omentin ratio ≥ 0.26 had Odds of 3.97 of developing DN, which was statistically significant (CI 2.36-6.68). Therefore, a ratio of ≤ 0.26 was found to be kidney protective among diabetes mellitus patients.
From the results of this present study, we recommend that estimation of serum IL-6: omentin 1 ratio of T2DM will aid in identifying early stages of DN before the onset of microalbuminuria.
在印度,糖尿病肾病(DN)是慢性肾脏病的最常见原因。及时发现微量白蛋白尿并进行适当干预可以逆转或阻止肾病进展。糖尿病肾病的发病机制表明,在糖尿病患者肾脏早期受累时,炎症和纤维化从肾小管进展到肾小球损伤。本研究旨在阐明趋化因子、网膜素 1 和白细胞介素 6(IL-6)与微量白蛋白尿的关系。
本横断面观察性研究是在印度奥里萨邦全印度医学科学研究所的普通医学和生物化学系合作进行的,时间为 2019-2020 年。我们的研究组包括 116 名糖尿病患者。根据尿液白蛋白水平,他们分为两组,每组 58 人;第 1 组(对照组)UACR<30μg/mg,eGFR>90ml/min,第 2 组(病例组)UACR≥30μg/mg,<300μg/mg,eGFR>60ml/min和<90ml/min。检测血清网膜素 1 和 IL-6、肌酐、糖化血红蛋白(HbA1c)、空腹(FBS)和餐后血糖(PPBS)、血脂、总蛋白、白蛋白、空腹胰岛素、HOMA-IR。
本研究表明,与无 DN 的 T2DM 相比,DN 组的网膜素 1 水平降低,IL-6 水平升高。计算出的风险估计表明,IL-6:网膜素 1 比值≥0.26 的糖尿病患者发生 DN 的几率为 3.97,具有统计学意义(CI 2.36-6.68)。因此,在糖尿病患者中,比值≤0.26 被认为具有肾脏保护作用。
从本研究的结果来看,我们建议估计 T2DM 患者的血清 IL-6:网膜素 1 比值有助于在微量白蛋白尿发生之前识别 DN 的早期阶段。