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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...
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.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751