Vitality of proinflammatory cytokine, scavenger protein and atherosclerotic plaque markers in risk prediction of diabetic nephropathy

Introduction: About 10 to 40% Type 2 diabetes (T2DM) suffer from kidney failure. Patients with uncontrolled diabetes develop ESRD require kidney transplantation, haemodialysis or peritoneal dialysis. Early detection of kidney injury by evaluating gene expressions of IL-6, IL-10 CD36 and LDLr in T2DM with microalbuminuria minimizes the risk of DN. Methods: This study includes 241 subjects were included after screening for T2DM by measurement of blood glucose in fasting, post-prandial, glycosylated haemoglobin and microalbumin. Subjects were randomised after written consent and enrolled as per inclusion/ exclusion criteria. Categorization of subjects in three study groups were done on the basis of T2DM duration 3-5 years, Glycosylated haemoglobin level (HbA1c) [greater than or equal to] 7.0% with fasting blood glucose [greater than or equal to] 126 mg/dl) and microalbuinuria (30-300 mg/dl) in study group. Blood samples were processed for other renal parameters (photometric assay) & rt-PCR to check expressions of IL-6, IL-10, CD36 and LDLr. Results: Data was analysed by R-software and observed that all renal and lipid parameters found within normal range except albumin/ creatinine ratio (p =.012), e-GFR (p =.00) and cholesterol (p =.00). Descriptive post hoc analysis showed high significance (p=.00) for IL-6, IL-10 and CD36, LDLr in microalbuinuria subjects. Conclusion: It was concluded that renal and lipid parameters are not enough to prevent DN even in microalbuminuria. Early detection of gene expressions of IL-6, IL-10 and CD36, LDLr predict risk of kidney injury. Therefore proinflammatory (11-6, IL-10) and scavenger/ atherosclerotic (CD-36, LDLr) expression may help to predict risk of DN and prevent morbidity & mortality of kidney. Key words: Diabetes mellitus, microalbuminuria, gene expressions, risk prediction