Key result
Plasma atrial natriuretic peptide levels were significantly higher in patients with macroalbuminuria and strongly correlated with TNF-α (r = 0.876), IL-6 (r = 0.816), and adiponectin (r = 0.772).
Why the study?
ANP is associated with CKD without diabetes, but its relationships with cytokines and clinical variables in type 2 diabetic nephropathy required investigation.
Cross-Sectional (n=81)
No
Effect estimate: r = 0.876 for TNF-α, r = 0.816 for IL-6, r = 0.772 for ADP
p-value: p=<0.001
Elevated plasma ANP levels in patients with type 2 diabetes are strongly correlated with macroalbuminuria and increased inflammatory cytokines, suggesting ANP may play a role in the progression of diabetic nephropathy.
ANP-inflammation links in T2DM nephropathy remain hypothesis-generating; prospective studies needed before any clinical consideration.
BACKGROUND: Atrial natriuretic peptide (ANP) is a cardiovascular and metabolic hormone that has been identified recently as being associated with chronic kidney disease (CKD) without diabetes. Cytokines such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and adiponectin (ADP) contribute to the development of type 2 diabetes (T2DM). The aim here was to investigate the relationships of ANP with cytokine levels and clinical variables in T2DM nephropathy patients. METHODS: A total of 81 participants with T2DM were recruited, including 37 patients with normoalbuminuria, 23 patients with microalbuminuria and 21 patients with macroalbuminuria. Serum concentrations of ANP and cytokines were measured using enzyme-linked immunosorbent assay (ELISA) kits. The correlations between ANP and clinical variables were analyzed. Multiple linear regression and logistic regression models were constructed to test the associations between ANP and the severity and presence of albuminuria. RESULTS: The macroalbuminuria patients exhibited higher plasma levels of ANP, TNF-α, IL-6, and ADP; higher serum creatinine (Cr) and blood urea nitrogen (BUN); and longer duration of diabetes mellitus (DM) than the patients with normoalbuminuria and microalbuminuria. Plasma ANP level was significantly associated with TNF-α (r = 0.876, p < 0.001), IL-6 (r = 0.816, p < 0.001) and ADP (r = 0.772, p < 0.001), independent of the duration of DM or the BUN concentration. CONCLUSION: ANP is higher in type 2 diabetes mellitus nephropathy subjects, especially those who have macroalbuminuria, which is associated with compensatory responses to inflammation.
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Liu et al. (2021) conducted a cross-sectional in Type 2 diabetes mellitus with diabetic nephropathy (n=81). Elevated atrial natriuretic peptide (ANP) levels vs. Lower ANP levels / Normoalbuminuria was evaluated on Correlation between plasma ANP levels and inflammatory cytokines (TNF-α, IL-6, ADP) (r = 0.876 for TNF-α, r = 0.816 for IL-6, r = 0.772 for ADP, p=<0.001). Plasma atrial natriuretic peptide levels were significantly higher in patients with macroalbuminuria and strongly correlated with TNF-α (r = 0.876), IL-6 (r = 0.816), and adiponectin (r = 0.772).
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