Soluble tumor necrosis factor receptor 1 useful Biomarker For Proteinuria Staging In Type-2-Diabetes Mellitus

Diabetic nephropathy is a serious complication of type 2 diabetes mellitus that can lead to end-stage renal failure if not identified and managed promptly. Researchers have been exploring various biomarkers to aid in the early detection of diabetic nephropathy, and a recent study published in the Journal Of The Association Of Physicians Of India sheds light on the potential role of soluble tumour necrosis factor receptor 1 (sTNFR1) in this context.

The study was conducted by Raghul Lourdusamy and colleagues on 160 subjects using a case-control methodology, aimed to investigate the association of sTNFR1 levels with different stages of proteinuria, including normoalbuminuria, microalbuminuria, and macroalbuminuria. Additionally, a group of individuals with normal glucose tolerance served as healthy controls.

The findings of the study were:

● The study observed that soluble tumour necrosis factor receptor 1 (sTNFR1) levels were highest in the MAC group, followed by the microMAC group.

● There were no statistically significant differences in sTNFR1 levels between the NGT and NA groups.

● Using regression models and controlling for potential confounding factors, the researchers found a significant association between sTNFR1 and MIC (odds ratio [OR] - 6.491, 95% confidence interval [CI] - 1.868-22.55) as well as MAC (OR per standard deviation - 15.28, 95% CI - 3.76-62.15, p < 0.001).

● To determine the diagnostic accuracy of sTNFR1, receiver operator curve (ROC) analysis was performed.

● The analysis indicated that a cut-off point of 1832 pg/mL for sTNFR1 had a C-statistic of 0.685, providing 52% sensitivity in discriminating MI from NA.

● A cut-off point of 2050 pg/mL for sTNFR1 had a C-statistic of 0.8177, yielding 77% sensitivity in identifying MAC.

These findings suggest that measuring sTNFR1 levels could serve as a valuable tool in the early identification of individuals at risk of developing macroalbuminuria, allowing for timely intervention and prevention of end-stage renal failure. However, further research and validation studies are necessary to establish the clinical utility of sTNFR1 as a diagnostic biomarker for diabetic nephropathy.

In conclusion, this study highlights the potential of soluble tumour necrosis factor receptor 1 (sTNFR1) as a promising biomarker for identifying stages of proteinuria, particularly macroalbuminuria, in individuals with type 2 diabetes mellitus. Early detection of diabetic nephropathy is crucial for implementing appropriate interventions and preventing the progression of renal complications. The use of sTNFR1 as a diagnostic tool may contribute to improved patient outcomes and better management of diabetic nephropathy.

Reference:

Lourdusamy R, Gokulakrishnan K, Nilavan E, et al. Soluble TNFR1 Levels in Type 2 Diabetes and its Association with Stages of Proteinuria. J Assoc Physicians India 2023;71(6):26–29.