Assessment of Correlation Between Serum Chemerin Concentrations In Renal Dysfunction In Type 2 Diabetic Patients

Abstract

SUMMARY AND CONCLUSION D iabetic nephropathy is a serious microvascular complication of diabetes mellitus. The decrease in renal function of diabetic nephropathy is characterized by glomeruler dysfunction, which is closely related to elevated urinary albumin excretion. Diabetic nephropathy has been categorized according to urinary albumin/ creatinine ratio into normoalbuminuria (urinary A/C ratio< 30 mg/gm), microalbuminuria (urinary A/C ratio (UACR) >30 mg /gm and <300 mg/gm) and macro-albuminuria (urinary A/C ratio >300 mg/gm). Chemerin is an adipokine secreted mainly from adipose tissue. Chemerin levels have been reported to be associated with components of the metabolic syndrome, including elevated levels of body mass index, plasma triglycerides, and blood pressure. Chemerin has been shown to induce insulin resistance in skeletal muscle cells. The aim of the present work was to study serum chemerin levels and determine its association with kidney functions and albuminuria in patients with type 2 diabetes mellitus. The study was conducted on sixty (60) adult patients with type 2 diabetes mellitus,30 males and 30 females whose mean ages were 45.8±4.5 years. The patients were classified according to their microalbumin levels in urine (UACR) into, Group I included 20 patients, 9 female and 11 males, whose ages were 43.9±4 diagnosed to have type 2 diabetes mellitus with microalbumin less than 30 mg/gm creatinine, group II included 20 patients,11 female and 9 males with mean age 46.3±4.2 with type 2 diabetes mellitus with microalbumin range from 30 mg up to 300 mg/gm creatinine and group III included 20 patients, 10 females and 10 males with mean age 47± 4 with type 2 diabetes mellitus with microalbumin more than 300 mg/gm creatinine Their results were compared with twenty (20) healthy subjects (10 males and 10 females) apparently healthy controls whose ages were 45±9 years. For all subjects UACR, fasting plasma glucose, post prandial blood glucose, HbA1c, creatinine, e GFR, serum insulin, serum chemerine and HOMA-IR were measured. In the present study, a highly significant elevation in serum chemerin levels was detected in diabetic patients compared to normal controls. In addition, a significant elevation in serum chemerin levels in patients with micro-albuminuria compared with patients with normoalbuminuria and normal controls. Moreover, results of the present study demonstrated that a highly significant elevation in serum chemerin concentrations in patients with macroalbuminuria compared with normal controls, patients with normoalbuminuria and patients with microalbuminuria. In a correlation study between serum chemerin and other studied parameters in diabetic patients, a significant positive correlation was found between serum levels of chemerin,, FBS(r 0.753, P < 0.001), PPS(r 0.500, P 0.001), serum creatinine(r 0.859, P <0.001), UACR(r 0.943, P< 0.001), HbA1c(r 0.749, P< 0.001), serum insulin (r 0.623,P <0.001) HOMA-IR (r 0.868, P <0.001). On the other hand, a highly significant negative correlation between serum chemerin and e GFR(r -0.658, P < 0.001) was observed in patients group.