Endocrine Abstracts

Proinflammmatory cytokines including interferon gamma (IFNg) are known to be involved in the pathogenesis of diabetic nephropathy. The aim of this study was to assess serum level of IFNg and its clinical correlates in patients with type 2 diabetes and early CKD receiving different types of treatment. We investigated 64 patients with type 2 diabetes and CKD stages 1-3. Group 1 included 20 patients on insulin therapy. Group 2 included 44 patients on metformin or combined oral hypoglycemic therapy. Groups were comparable on the basis of sex, age, body mass index and eGFR. In addition to routine clinical tests, we measured serum levels of ferritin, homocysteine, interleukin-6 and IFNg. Mann-Whitney U-test and Spearmen’s correlation coefficient (rs) were used for statistical analysis. Serum level of IFNg was elevated in 20.0% patients from group 1 and 31.8% patients from group 2. Mean level of this cytokine was significantly higher in group 2 as compared to group 1 (14.6±2.4 pg/ml vs. 6.5±1.7 pg/ml, respectively, P=0.018). In both groups serum concentration of IFNg had no significant correlations with age, body mass index, eGFR (CKD-EPI), albuminuria, hemoglobin, homocysteine, total cholesterol, lipid fractions, and interleukin-6. Only in group 1 (but not in group 2) the level of IFNg correlated with serum ferritin level (rs=−0.629, P=0.003) and platelets count (rs=0.547, P=0.013). The results of the study suggest that insulin therapy is associated with lower serum level of IFNg in patients with type 2 diabetes and early CKD after adjustment for sex, age, body mass index and eGFR. This could be related to anti-inflammatory effects of insulin. In insulin-treated patients, serum level of IFNg correlates negatively with serum ferritin level and positively – with platelets count.