Association of transforming growth factor-beta 1 [TGF-beta1] and monocyte chemoattractant protein-1 [MCP-1] with type II diabetic nephropathy

To estimate the levels of serum transforming growth factor-beta 1 [TGF-beta1], and urinary moncyte chemoattractant protin-1 [MCP-1] throughout the course of diabetic nephropathy [DN], and to find their possible relationship. Also, to assess the relationship between their levels and parameters of renal injury such as albumin/creatinine ratio [ACR] and estimated glomerular filtration rate [eGFR]. Serum TGF-beta1, urinary MCP-1, estimated glomerular filtration rate [eGFR] [as a parameter of renal injury] and glycosylated hemoglobin [HbA1C] [as an index of glycemic control] were measured in 60 patients with type II diabetes mellitus with different degrees of nephropathy [20 with normoalbuminuria, 20 with microalbuminuria and 20 with macroalbuminuria] and compared with 20 matched healthy control subjects. Both levels of serum TGF-beta1 and urinary MCP-1 were significantly higher in patients with micro- and macroalbuminuria [137.8 +/- 69.5 and 329.25 +/- 41.46 ng/dl, respectively for TGF-beta1] [167.41 +/- 50.23 and 630.87 +/- 318.10] ng/g creatinine, respectively for MCP-1] as compared with normoalbuminuric patients and healthy controls [33.25 +/- 17.5 and 29.64 +/- 10.57 ng/dl. respectively for TGF-beta1] [63.85 +/- 21.15 and 61.50 +/- 24.81] ng/g creatinine, respectively for MCP-1] p<0.001. There was a positive significant correlation between levels of serum TGF-beta1 and those of urinary MCP-1 [r=0.73, p<0.001]. Serum TGF-beta1 and urinary MCP-1 correlated positively with HbA 1C [r= 0.49 and 0.55, respectively, p<0.05 for both] and inversely with eGFR [r= -0.69 and -0.60, respectively, p<0.001 for both]. The progression of diabetic nephropathy may he associated with increased levels of serum TGF-beta1 and urinary MCP-1 that are closely- inked to renal damage and the degree of glycemic control. Thus, it seems possible that adequate glvcemic control and TGF-beta1 and MCP-1 antagonists might be helpful in attenuating the progression of nephropathy in diabetic patients