Association of NFkB1 Gene Polymorphism with Inflammatory Markers in Patients of Type 2 Diabetes Mellitus with or without Renal Involvement in Eastern India

Aims: To evaluate the association of Nuclear factor kappa B1(NFkB1) gene polymorphism with inflammatory markers Urinary Monocyte Chemoattractant Protein 1 (UMCP1) and Tumor Necrosis Factor alfa (TNF alfa) in Patients of diabetes mellitus with or without renal involvement in Eastern India. Material and Methods: Consecutive Patients of Type 2 Diabetes Mellitus (DM) with or without microalbuminuria attending SCB MEDICAL COLLEGE and HOSPITAL Medical OPDs in between September 2018 to September 2019 were recruited in this study. Patients were subjected to blood and urine investigations. DNA extraction and Restriction fragment Length Polymorphism (RFLP) was done in Department of Biochemistry. Controls were unrelated healthy attendants with no history of Diabetes Mellitus, HTN, Chronic Kidney Disease (CKD). Results: Mean Systolic BP, Fasting Blood Glucose, Post Prandial Blood Glucose, HBA1c, Total Cholesterol were significantly higher in diabetes mellitus and diabetic nephropathy groups than control group. Estimated Glomerular Filtration Rate was significantly lower in diabetic nephropathy (p value < 0.001). UMCP1, Urinary Albumin Creatinine Ratio, TNF alfa were higher in diabetes mellitus and nephropathy with p value (<0.001, 0.006 < 0.001) respectively. In between DM and Diabetic Nephropathy groups nfkb1 gene expression, umcp1 and tnf alfa levels were significantly increased in Diabetic nephropathy with p value 0.019, <0.01, 0.001 respectively. Insertion/insertion NFkB1 gene polymorphisms were more in diabetic nephropathy group and were positively correlated with inflammatory markers UMCP1 (r = 0.517, p < 0.01) and TNF alfa (r = 0.172, p = 0.19). Conclusion: insertion/insertion NFkB1 gene polymorphism increases the risk of nephropathy by 2.52 times (OR = 2.52, 95% CI: 0.04 - 0.63, p value = 0.019) in diabetes patients in eastern India.

Study of Lipid Abnormalities in Type 2 Diabetes Mellitus Patients with Nephropathy in Eastern India

Background: Diabetic nephropathy is one of the major complications of diabetes. Nephropathy patients must be evaluated for dyslipidemia as it is an established risk factor for cardiovascular events. We compared the degree of dyslipidemia among type 2 diabetes mellitus (T2DM) subjects with or without nephropathy and analyzed the factors associated with nephropathy among them. Methods: In this retrospective study, T2DM patients with overt nephropathy were enrolled in the study group (n = 50);without nephropathy were enrolled in the control group (n = 50). Both groups were matched for age duration of diabetes. After taking informed consent anthropometrical clinical examinations were done. Biochemical investigations (Total cholesterol, TG, HDL, LDL, VLDL, sdLDL-C, S. urea, S. creatinine were done in SCB MCH, Biochemistry department. Urine microalbumin per gm of creatinine was done. TG/HDL-C ratio, a surrogate marker for small, dense, LDL particles (sdLDL), and estimated glomerular filtration rate (eGFR) were calculated using equations. Results were analyzed statistically using SPSS version 20. Results: Mean Total cholesterol, TG, LDL, sdLDL are significantly high in nephropathy patients with p values 0.026, 0.012, 0.014, 0.04 respectively. Estimated GFR has a significant positive correlation with TCHOL (r = &minus;0.850, p = 0.01), TG (r = &minus;0.14, p = 0.008), LDL (r = &minus;0.62 p = 0.037). Estimated GFR has a significant negative correlation with S. urea (r = &minus;0.587, p ≤ 0.01), S. creatinine (r = &minus;0.59, p ≤ 0.01), UACR (r = &minus;0.47, p ≤ 0.01). Dyslipidema sdLDL is significantly more in nephropathy group in comparison to diabetic group with p values 0.033, 0.045 respectively. Conclusion: Our study shows that dyslipidemia was highly prevalent among subjects with nephropathy. So cardiovascular risks can be averted by regular screening for dyslipidemia in diabetic nephropathy patients.