Estresse oxidativo e inflamação na nefropatia diabética

Abstract

Oxidative stress and inflammation play an important role in the development and progression of chronic kidney diseases. The effect of excess weight on the abnormal glucose metabolism, inflammation stimulus, oxidative stress, and fibrosis, which induce obesity-related renal disease, are no different from the microvascular damage produced by diabetes mellitus during diabetic nephropathy (ND). In the scenario of kidney damage induced by excess nutrients (hyperglycemia and hyperlipidemia), in the context of renal diseases related to obesity and diabetes, there is a growing recognition that the shared pathophysiological and histological similarities point to the overlap of injury mechanisms when these conditions are associated. To confirm this relationship, the objective of the study was to determine whether there are differences between inflammatory biomarkers (interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α) and monocyte chemotactic protein 1 (MCP-1)] among carriers of eutrophic and overweight ND. This dissertation presents two articles, the first one is a review of the literature, titled: Kidney disease of diabetes: cross-linking between hyperglycemia, redox imbalance and inflammation; and, the main article: Does excess weight influence the serum levels of inflammatory biomarkers of patients with diabetic nephropathy? This is a cross-sectional study conducted with patients with type 2 diabetes mellitus and ND in the non-dialytic stages 1-5, comprising the stages 1 to 5 of renal disease. Methodologically, demographic, clinical, laboratory and inflammatory markers (interleukin-6, interleukin-8, tumor necrosis factor alpha and monocyte chemotactic protein 1) were determined for the enzyme-linked immunosorbent assay (ELISA). The groups were allocated through body mass index (BMI) (non-obese and obese). For all hypothesis tests, alpha = 5% was adopted. The sample consisted of 29 patients. Overweight was present in 51.7% (n = 15) of the patients. When compared by groups, all anthropometric parameters (weight, WC, BMI and% WC) differed significantly between groups (p <0.001). There was no significant difference in most biochemical parameters, except for fasting glycemia that was higher in the eutrophic group (p <0.05). The median / median values of the inflammatory biomarkers, IL-8, TNF-α, MCP-1 did not differ significantly in non-obese and obese patients, except for serum IL-6 levels in obese patients p <0.05). The presence of obesity during the course of nephropathy significantly elevates IL-6 levels in diabetic humans.