Evaluation of IL-6, IL-10, and TNF-α as Predictive Inflammatory Biomarkers in Type 2 Diabetes and Early Nephropathy IL-6, IL-10, and TNF-α in Diabetic Nephropathy
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Abstract
Low-grade chronic inflammation is central to the pathogenesis of Type 2 diabetes and early diabetic nephropathy; therefore, the predictive biomarkers of the early renal and metabolic dysfunction could be cytokines like IL-6, TNF-α and IL-10. This study intended to assess the IL-6, IL-10, and TNF-al levels in Type 2 diabetes mellitus patients and to determine their possible application as predictive inflammatory biomarkers of early diabetic nephropathy. The study was a case-control study with 150 participants (100 patients with T2DM and 50 control), who admitted to Al-Habbobi Teaching Hospital, Iraq for the period extended January 2024 to February 2025. Diabetic patients were categorized into two groups first with nephropathy and the second without. Diagnosis was based on American Diabetes Association criteria (ADA) criteria and nephropathy was based on microalbuminuria and eGFR. Fasting blood sampling and clinical assessment were done. The biochemical parameters were automatically measured and level of IL-6, IL-10, and TNF-α were measured using ELISA. Ages and sex of T2DM patients were similar to the controls but with greater BMI, blood pressure, HbA1c, and lower eGFR. Inflammatory imbalance was manifested by a high level of IL-6, TNF-α, and CRP and a decrease in IL-10. Patients with nephropathy at an early stage possessed increased pro-inflammatory indicators and ACR with reduced IL-10. There was a positive correlation between IL-6 and TNF-α and HbA1c and ACR and negative correlation between eGFR. Regression analysis revealed that IL-6, TNF-α, HbA1c and BMI were independent predictors of early nephropathy. In conclusion, high IL-6 and TNF-α and low IL-10 are indications of chronic inflammatory responses that lead to insulin resistance, endothelial dysfunction, and early kidney damage in T2DM. These cytokines alone foresee nephropathy because of their effects on oxidative stress, mesangial expansion, and glomerular permeability.
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