Circulating TNF receptor 2 is associated with the development of chronic kidney disease in non-obese Japanese patients with type 2 diabetes

Aims: Chronic low-grade inflammation and/or obesity are suggested to induce chronic kidney disease (CKD) in patients with type 2 diabetes. This cross-sectional study was performed to investigate the relationship between inflammatory biomarkers and CKD in non-obese patients with type 2 diabetes. Methods: 106 non-obese Japanese patients with type 2 diabetes were recruited for the measurement of GFR, TNF, HMW adiponectin, leptin, hsCRP and some variables including urinary albumin. BMI, serum creatinine, and urinary albumin levels were 22.2 +/- 0.2 kg/m(2) (17.1-24.9 kg/m(2)), 0.76 +/- 0.02 mg/dl (0.39-1.38 mg/dl), 40.4 +/- 4.3 mg/gCr (1.6-195.0 mg/gCr), respectively. They were stratified into two groups based on the value of eGFR: low eGFR (eGFR <60 ml/min/1.73 m(2)) and normal eGFR (eGFR >60 ml/min/1.73 m(2)). Logistic regression analysis was used for statistical analysis. Results: Whereas univariate logistic regression analysis showed that gender, diabetes duration, triglyceride, HDL cholesterol, uric acid, urinary albumin, and soluble TNF receptors (sTNF-R1, sTNF-R2) are associated with the development of stage 3 CKD, multivariate logistic regression analysis revealed that sTNF-R2 (Odds ratio 1.003, 95% confidence interval 1.000 to 1.005, P = 0.030) showed significant associations with the development of stage 3 CKD. Conclusions: Circulating TNF receptor 2 is an independent risk factor for CKD in non-obese Japanese patients with type 2 diabetes. (C) 2013 Published by Elsevier Ireland Ltd.