Relationship Between Serum Tumor Necrosis Factor-Alpha Levels and Insulin Resistance in Patients with Chronic Renal Failure


Ulas T., BASTURK T., SAKACI T., UNSAL A., BORLU F.

TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, vol.32, no.1, pp.157-161, 2012 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 1
  • Publication Date: 2012
  • Doi Number: 10.5336/medsci.2011-23421
  • Journal Name: TURKIYE KLINIKLERI TIP BILIMLERI DERGISI
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.157-161
  • Keywords: Insulin resistance, renal insufficiency, chronic, tumor necrosis factor-alpha, CHRONIC KIDNEY-DISEASE, TNF-ALPHA, SENSITIVITY, INFLAMMATION, UREMIA, RISK, PREVALENCE, LEPTIN, NIDDM
  • Akdeniz University Affiliated: No

Abstract

Objective: Chronic renal failure is a chronic microinflammatory process of cytokine dysregulation and increased insulin resistance is a known concept in these patients. Tumor necrosis factor (TNF)-alpha is a proinflammatory cytokine and has been shown to increase in chronic renal failure patients in some studies. We planned this study to investigate TNF-alpha levels, insulin resistance values and interrelations in chronic renal failure patients. Material and Methods: A total of 60 subjects of whom 30 had chronic renal failure (15 females-group 1) and 30 were healthy controls (16 females-group 2) were included in the study. Serum creatinine, glomerular filtration rate levels, TNF-alpha, fasting plasma glucose, fasting insulin levels were studied and HOMA-IR was calculated. Results: Mean values of glomerular filtration rate were detected as follows; group 1: 42.05 +/- 24.60 ml/min and group 2: 106.67 +/- 17.10 ml/min, TNF-alpha values were found as group1:57.65 +/- 42.2 pg/ml and group 2:18.25 +/- 7.90 pg/ml and HOMA-IR values were found as group 1:3.71 +/- 2.56 and group 2: 2.37 +/- 1.45. When HOMA-IR and TNF-alpha values of group 1 and 2 were compared respectively, a statistically significant difference was detected (p<0.01) (p<0.001). However a negative or positive relationship was not detected in bivariate correlation of HOMA-IR and TNF-alpha (r=0.091, p=0.634). TNF-alpha was found to be an independent variable for chronic kidney disease in regression analysis (p=0.010). Conclusion: In this study, insulin resistance was present in subjects with chronic renal failure and level of TNF-alpha in circulation was higher compared to controls without chronic renal failure. However, TNF-alpha did not have an influence on insulin resistance.