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Journal of Diabetes Research
Volume 2014, Article ID 394206, 7 pages
http://dx.doi.org/10.1155/2014/394206
Research Article

TNF-α and Microalbuminuria in Patients with Type 2 Diabetes Mellitus

1Department of Nephrology, “Hippokratio” General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, 546 42 Thessaloniki, Greece
21st Propedeutic Department of Internal Medicine, Diabetes Center, “AHEPA” General Hospital, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece

Received 5 July 2014; Revised 11 September 2014; Accepted 19 September 2014; Published 22 December 2014

Academic Editor: Salwa Ibrahim

Copyright © 2014 I.-Th. Lampropoulou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. 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). Patients-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- (TNF-) 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- levels but had a strong correlation with urinary TNF- levels. Conclusions. In patients with type 2 DM, urinary, but not serum, TNF- levels are associated with the presence and severity of microalbuminuria.