The Association between Highly Sensitive C-Reactive Protein and Interleukin-18 with Nephropathy in a Sample of Type 1 Diabetic Egyptian Patients

Abstract
Background: Diabetic Nephropathy (DN) is a major complication of diabetes and the leading cause of end-stage renal disease that accounts for a large proportion of the excess mortality associated with Type-1 Diabetes (T1D). Inflammation and endothelial dysfunction have been hypothesized to play a role in the pathogenesis of DN. Highly sensitivity C-Reactive Protein (hs-CRP) and Interleukin-18 (IL-18) are associated with systemic inflammation and have been shown to be increased in individuals with Type 1 Diabetic nephropathy.
Aim of Study: In our study, we aim to determine the association between hs-CRP and IL-18 with nephropathy in a sample of type 1 diabetic Egyptian patients.
Patients and Methods: This study was conducted on 30 type-1 diabetic patients (Group I), who subdivided into three subgroups according to their urine Albumin Excretion Rate (AER); Group IA: 10 patients with AER <20mg/min, Group IB: 10 patients with AER ranges from 20-200mg/min. Group IC: 10 patients with AER is >200mg/min and 10 healthy subjects as a control (Group II). Patients and control were subjected to full history taking, full clinical examination, Fasting Plasma Glucose (FPG), Glycated Hemoglobin (HbA1c%), serum creatinine, Urinary Albumin Excretion (UAE), Highly-sensitive C-Reactive Protein (hs-CRP) by turbidimetry technique and Interleukin-18 (IL-18) by Enzyme-linked Immunosorbent Assay (ELIZA) technique. This work was done during the year 2017.
Results: There were statistically significant difference between control group and diabetic group regarding hs-CRP (4.25±6.62, 25.13±23.56), and IL-18 (2.85±0.74, 12.68± 29.12) with (p=0.009, p=0.037) respectively. In diabetic group, we found a positive significant correlation (p<0.001, p=0.012) between UAE and both; levels of hs-CRP (r=0.765), and IL-18 (r=0.453), respectively.
Conclusion: Hs-CRP and IL-18 are sensitive markers for diabetic nephropathy in type-1 diabetic patients.