Diabetic nephropathy (DN) is one of the significant causes of chronic kidney disease (CKD) and end stage renal disease (ESRD) globally. Cytokines play a vital role in the pathogenesis and progression of CKD. DN is considered as an inflammatory disease. Vitamin D is a reno-protective fat soluble agent, whose deficiency is associated with the levels of inflammatory molecules and progression of DN. Thus, the objective of this study was to analyse the expression of cytokines in diabetic patients with and without nephropathy and correlate with vitamin D levels.
Material: Clinical details and serum samples from 84 diabetic patients without nephropathy and 84 diabetics with nephropathy were collected. The separated serum was used to measure Vitamin D and Cytokines; IL-1, IL-6, TNF-α. Fasting insulin levels were measured and HOMA-IR was calculated.
Observation: Diabetics with & without nephropathy had hypovitaminosis D. Severe hypovitaminosis D (< 10 ng/ml) was observed in 36.9% nephropathy subjects when compared to diabetics without nephropathy (19%). The serum IL-6 levels were high (p<0.001) and IL-1 (p<0.001) and TNF- α (p<0.001) were low in diabetic patients with nephropathy.
Conclusion: Diabetics with and without nephropathy have low vitamin D. Severe hypovitaminosis D was observed in diabetic nephropathy subjects, when compared to diabetics. IL-6 is significantly increased in diabetic nephropathy. A weak negative correlation of IL-1 and TNF-α was seen with vitamin D in diabetics without nephropathy, whereas IL-6 had a weak negative correlation with vitamin D in diabetics with nephropathy.
© Journal of the Association of Physicians of India 2011.