The Influence Of Fluvastatin Treatment On Inflammatory Cytokines In Patients With Type 2 Diabetes And Diabetic Nephropathy

Objective: To study the impact of fluvastatin treatment on inflammatory cytokines in patients with type 2 diabetes and diabetic nephropathy, and to evaluate the protect role of fluvastatin treatment .Methods: 120 individuals were divided into 3 groups. Group 1 (DN) included 60 type 2 diabetes mellitus patients with microalbuminuria which had two subgroups: normal treatment group (DN1) and normal treatment plus fluvastatin treatment group (DN2); group 2 (DM) included 30 newly-diagonosed type 2 diabetes without microalbuminuria; while group 3 (NC) was normal control group including 30 healthy individuals. The serum levels of transforming growth factor-?1 (TGF-β₁), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) were detected with ELISA in those groups; and serum grucose, blood lipid, creatinine, c-reactive protein (CRP) were measured by automatic biochemistry analysis apparatus; The total urinary albumin for 24 hours was detected by dry-type chemical method , and urinary albumin excretion rate (UAER) was detected by RIA.Results:(1) The serum levels of CRP, TGF-β₁, IL-6, TNF-αwere compared between group NC, group DM and group DN. The results manifested that the serum levels of CRP, TGF- ?1, IL-6 , TNF-αof group DM were increased significantly compared to group NC(P<0.05), and the difference was more significant in group DN(P<0.01). The serum levels of TGF-β₁, IL-6, TNF-αof group DN were increased compared to group DM(P<0.01), and the serum level of CRP was also elevated (P<0.05). (2) Correlation analysis showed that serum levels of CRP, TGF-β₁, TNF-α, IL-6, total urinary albumin for 24 hours, ALB/Cr, course of disease were positively related to UAER. The coefficient correlation was 0.285(P<0.05), 0.317(P<0.05), 0.658(P<0.01), 0.556(P<0.01), 0.514(P<0.01), 0.691(P<0.01), 0.806(P<0.01) in separately; The multiple stepwise regression analysis discovered that the variety of UAER was lineal associated with course of disease, total urinary albumin for 24 hours and TNF-α. (3) The serum levels of TG, TC, ALB/Cr, UAER as well as CRP , TGF-β₁ , IL-6, TNF-αdecreased dramatically after therapy in group DN2 compared to DN1(P<0.05); And the indexs above had no obviously diffence whether the patients were treated or not in group DN1, while the results are contrary in group DN2. (4) The serum levels of total urinary albumin for 24 hours, ALB/Cr, UAER, CRP, TGF-β₁ , IL-6, TNF-αremarkably declined while the blood lipid with no significant difference(P>0.05) in the subgroup of normal blood lipid of DN2 after treatment compared to DN1(P<0.05). Conclusion: The inflammatory cytokines of CRP,TGF-?1,IL-6,TNF-αsignificantly increased in diabetes and dibetic nephropathy patients. Furthermore, those indexs in group DN were more significant. It suggested that the inflammatory cytokines participated the development and improvement of DN. Fluvastatin may improve renal function in diabetic patients through the activity of anti-inflammation and reduction of urinary albumin.