Monocyte Chemoattractant Protein-1, Interleukin-1 Beta and Neutrophil Gelatinase Associated Lipocalin are Upregulated in Patients with Diabetic Nephropathy

Abstract

Diabetes mellitus (DM) is the most prevalent metabolic non-communicable disease in the
world and diabetic microvascular and macro vascular complications cause significant morbidity and mortality. One of the most prevalent microvascular complications of DM is diabetic nephropathy (DN). Currently, there is a greater focus on early detection of nephropathy to bring about in best patient outcomes.
Chronic elevation of blood glucose level leads to the endothelial cells lining the blood vessels take more
glucose than normal. Since they don’t depend on insulin, then they form more surface glycoprotein than
normal and cause the basement membrane to grow thicker and weaker. In diabetes, the resulting problems are grouped under macro vascular complications due to damage to the arteries and microvascular
complications due to damage to the small blood vessels, damage to the kidney which can lead to chronic
renal failure, eventually requiring dialysis. Diabetes mellitus is the most cause of adult kidney failure
worldwide in the developed world. The aim of present study is to evaluate serum levels of Interleukin-1β
(IL-1β) and monocyte chemoattractant protein-1 (MCP-1) and urinary levels of neutrophil gelatinase-associated lipocalin (NGAL) in patients with type 2 diabetes (T2DM) according to the stage of nephropathy.
During the period from August 2018 to January 2019, a total of 300 subjects were recruited. Among them,
150 patients were suffering from T2DM that had been selected from those who attended the Center of Diabetes and Endocrinology in Al-Sadr Teaching Hospital in Najaf. These patients were classified into three
groups according to their albumin/creatinine ratio (ACR), including 50patients with mild diabetic
nephropathy, 50 patients with moderate diabetic nephropathy and 50 patients with severe diabetic
nephropathy. 150 apparently healthy subjects matching the same age with diabetic subjects were selected
as a control group. Significant elevation in MCP-1, IL-1β and NGAL levels have been found in mild, moderate and severe diabetic groups when compared to the control individuals. Biomarkers MCP-1, IL-1β
and NGAL may be highly linkedto the degree of proteinuria. These immunological parameters were significantly increased in diabetic nephropathy. Thus, there is a potential association between these mediators and incidence of diabetic nephropathy among Iraqi patients.