DIABETOLOGY / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study aimed to investigate the relationship between serum cytokine levels, particularly interleukin 6 (IL-6), and diabetic nephropathy (DN) in patients with type 1 (T1D) and type 2 diabetes (T2D).

Material and methods:
A cross-sectional study was conducted among 200 patients diagnosed with either T1D or T2D from January 2022 to December 2023 at the Endocrinology and Diabetes Department of Madinah Hospital, Saudi Arabia.

Results:
A total of 200 individuals with T1D (n = 100) or T2D (n = 100) were enrolled in this research. Male patients (54%) and those aged 30–50 (67.5%) dominated the cohort. About 50% had diabetes for less than 10 years, and 49.5% were overweight. 63.5% (n = 117) had a reduced glomerular filtration rate (GFR), whereas 46% (n = 92) had albuminuria. T1D patients were mostly normal weight, while T2D patients were overweight or obese. Both diabetes types had identical kidney damage stages. T1D patients were more likely to have moderately elevated albuminuria (53% vs. 37%, p < 0.05) than T2D individuals. T1D patients had considerably lower serum cytokine levels than T2D patients. IL-6 levels were moderately correlated with fasting blood glucose (FBG) (r = –0.318, p < 0.01) and HbA1c (r = –0.319, p < 0.01) in T1D patients. IL-6 had a modest correlation with renal dysfunction markers including GFR and urine albumin-creatinine ratio (UACR) (r = –0.250, p < 0.05 and r = 0.338, p < 0.001, respectively). In T1D patients there was a weak but significant correlation between GFR and IL 6.

Conclusions:
Lower serum IL-6 levels in T1D patients are linked to delayed onset of kidney damage. The pro-inflammatory role of IL-6 may contribute to the development of DN in T1D patients, as indicated by its association with albuminuria and renal function markers. Further research is warranted to explore IL-6 as a potential therapeutic target in diabetic nephropathy.
REFERENCES (22)
1.
Navarro-González J, Mora-Fernández C, de Fuentes MM, et al. Inflammatory molecules and pathways in the pathogenesis of diabetic nephropathy. Nat Rev Nephrol 2011; 7: 327-40.
 
2.
Tesch GH. Role of interleukin-17 in inflammation, tissue damage, and fibrosis in experimental models of kidney disease. Cytokine Growth Factor Rev 2018; 41: 68-77.
 
3.
Navarro-González JF, Mora-Fernández C. The role of inflammatory cytokines in diabetic nephropathy. J Am Soc Nephrol 2008; 19: 433-42.
 
4.
Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Diabetes Care 2014; 37: 2864-83.
 
5.
Tanaka S, Sugiura Y, Saito H. Interleukin-6 in renal pathology. Pathol Int 1994; 44: 609-15.
 
6.
Sprague AH, Khalil RA. Inflammatory cytokines in vascular dysfunction and vascular disease. Biochem Pharmacol 2009; 78: 539-52.
 
7.
Duran-Salgado MB, Rubio-Guerra AF. Diabetic nephropathy and inflammation. World J Diabetes 2014; 5: 393-8.
 
8.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157-63.
 
9.
Levey AS, Coresh J, Tighiouart H, et al. Measured and estimated glomerular filtration rate: current status and future directions. Nat Rev Nephrol 2020; 16: 51-64.
 
10.
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39 (2 Suppl 1): S1-266.
 
11.
Molitch ME. Diabetic nephropathy: a clinical update. Endocr Rev 2003; 24: 278-81.
 
12.
Gross JL, de Azevedo MJ, Silveiro SP, et al. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care 2005; 28: 164-76.
 
13.
Perkins BA, Ficociello LH, Silva KH, et al. Regression of microalbuminuria in type 1 diabetes. N Engl J Med 2007; 348: 2285-93.
 
14.
Lim AK, Tesch GH. Inflammation in diabetic nephropathy. Mediators Inflamm 2012, 2012, 146154.
 
15.
Kim SS. The role of inflammatory cytokines in diabetic nephropathy. J Diabetes Res 2013; 1-7.
 
16.
Ruiz-Ortega M, Ruperez M, Esteban V, et al. Angiotensin II: a key factor in the inflammatory and fibrotic response in kidney diseases. Nephrol Dialysis Transplant 2001; 16: 3-6.
 
17.
Lim AKH. Urinary cytokines and cytokine receptors as biomarkers of disease activity in experimental diabetic nephropathy. Nephrol Dialysis Transplant 2005; 20: 2399-407.
 
18.
Ridker PM, Everett BM, Thuren T, et al. Anti-inflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017; 377: 1119-31.
 
19.
Su H, Lei CT, Zhang C. Interleukin-6 signaling pathway and its role in kidney disease: an update. Front Immunol 2017; 21: 405.
 
20.
Akbari M, Hassan-Zadeh V. Hyperglycemia affects the expression of inflammatory genes in peripheral blood mononuclear cells of patients with type 2 diabetes. Immunol Investig 2018; 47: 654-65.
 
21.
Sueud T, Hadi NR, Abdulameer R, et al. Assessing urinary levels of IL-18, NGAL and albumin creatinine ratio in patients with diabetic nephropathy. Diabetes Metab Syndr 2019; 13: 564-8.
 
22.
Donate-Correa J, Ferri CM, Sánchez-Quintana F, et al. Inflammatory cytokines in diabetic kidney disease: pathophysiologic and therapeutic implications. Front Med 2021; 22: 628289.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top