Correlation between the levels of blood lipid and serum inflammatory mediators and renal function in patients with early diabetic nephropathy

Yao Zhaojun; Jiao Yanhong

doi:10.3969/j.issn.1672-8521.2025.03.008

Abstract：Objective:To investigate the correlation of blood lipids and serum inflammatory mediators with renal function in patients with early diabetic nephropathy(DN).Methods:A total of 177 patients with type 2 diabetes mellitus(T2DM)admitted to Tianjin Railway Center for Disease Control and Prevention and Tianjin 4th Center Hospital from April 2023 to April 2024 were selected.Among them,patients with early DN were included in the early DN group(81 cases)and those without early DN were included in the T2DM group(96 cases).Meanwhile,another 30 healthy individuals who underwent physical examinations during the same period were selected as the healthy control group.Fasting venous blood was collected from patients on the morning of the second day after admission,and fasting venous blood was collected from the healthy control group.Blood triglycerides(TG),inflammatory mediators[high-sensitivity C-reactive protein,(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and serum creatinine were detected,and the estimated glomerular filtration rate(eGFR)level was calculated.According to the eGFR level,81 patients in the early DN group were divided into Group A(eGFR≥90 mL·min-1·1.73 m-2,n=22),Group B(eGFR:61-89 mL·min-1·1.73 m-2,n=35)and Group C(eGFR:45-60 mL·min-1·1.73m-2,n=24).The levels of blood lipids and inflammatory mediators in patients with different eGFR in the early DN group were compared.Logistic regression analysis was used to analyze whether the levels of TG,hs-CRP,IL-6 and TNF-α were risk factors for DN in patients with T2DM,and to analyze their correlations with renal function.Results:The levels of TG,hs-CRP,IL-6 and TNF-α in the early DN group[(2.89±1.13)mmol/L,(15.38±2.82)mg/L,(0.48±0.04)ng/L and(6.66±1.34)ng/mL]＞the T2DM group[(1.98±0.85)mmol/L,(9.23±1.24)mg/L,(0.47±0.02)ng/L and(4.34±1.08)ng/mL]＞the healthy control group[(1.32±0.29)mmol/L,(3.77±0.85)mg/L,(0.45±0.05)ng/L and(1.72±0.31)ng/mL](F=39.144,431.884,4.051,234.722,P＜0.05).Logistic regression analysis showed that elevated levels of TG,hs-CRP,IL-6 and TNF-α were risk factors for early DN(OR=3.900,2.255,2.678,2.866,respectively,P＜0.05).Among early-stage DN patients,TG,hs-CRP,IL-6 and TNF-α in group C[(3.21±1.08)mmol/L,(16.75±2.89)mg/L,(0.50±0.03)ng/L and(7.37±1.06)ng/mL]were higher than those in group A[(2.32±0.98)mmol/L,(14.19±2.78)mg/L,(0.47±0.04)ng/L and(5.56±1.23)ng/mL],and the level of hs-CRP was also higher than that in group B[(15.19±2.46)mg/L].The levels of TG,IL-6 and TNF-α in group B[(3.04±1.13)mmol/L,(0.49±0.03)ng/L and(6.87±1.16)ng/mL]were higher than those in group A(F=4.482,5.393,4.918,15.191,P＜0.05).Correlation analysis found that TG,hs-CRP,IL-6 and TNF-α were negatively correlated with eGFR(r=-0.338,-0.331,-0.367,-0.491,respectively,P＜0.05).Conclusions:The levels of TG,hs-CRP,IL-6 and TNF-α in patients with DN are significantly elevated.They are high-risk factors for the occurrence of DN and also have a significantly negative correlation with eGFR,which deserves clinical attention.