Correlation between the levels of serum HMGB1 and TNF-α and cardiac function in patients with diabetic kidney disease

Abstract:

Objective: To explore the correlation between the levels of serum high-mobility group box-1（HMGB1） protein and tumor necrosis factor-α（TNF-α） and the cardiac function in patients with diabetic kidney disease（DKD）. Methods: A total of 122 DKD patients（DKD group） hospitalized in the Department of Endocrinology, The Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University between June 2019 to June 2020 were randomly selected into this study. According to the urinary protein-creatinine ratio，the subjects were divided into 58 cases in the microalbuminuria group，42 cases in the macroalbuminuria group，and 22 cases in the renal impairment group. Meanwhile，106 healthy people examined during the same period were collected as a healthy control group. The levels of fasting blood glucose，blood lipids and kidney function（urea nitrogen and creatinine） and urinary protein-creatinine ratio were detected in all subjects. Serum HMGB1 and TNF-α levels were detected by enzyme-linked immunosorbent assay（ELISA）. The left ventricular ejection fraction（LVEF），left ventricular end-diastolic dimension（LVEDD） and left ventricular end-systolic dimension（LVESD） were measured by echocardiography. Analysis of variance was used for comparison between groups. Pearson correlation test was used to analyze the correlation between serum HMGB1 and TNF-α levels and the cardiac function of patients with DKD. Logistic multiple linear regression was used to analyze the influencing factors of cardiac function in patients with DKD. Results: ①The fasting blood glucose，LDL-C，urea nitrogen，creatinine，and UALB/Cr ratio of the DKD group were significantly higher than those of the healthy control group（all P<0.05），while the HDL-C level was lower compared to the healthy control group（P<0.05）. ②HMGB1，TNF-α，LVEDD，and LVESD gradually increased with the progression of DKD，while the LVEF gradually decreased with the progression of the disease. ③Serum HMGB1 and TNF-α levels in the DKD group were negatively correlated with LVEF，and significantly positively correlated with LVEDD and LVESD（all P<0.05）. ④Logistic multiple linear regression showed that HMGB1 had the greatest impact on the cardiac function of patients with DKD. For every increase of 1 mmol/L in HMGB1，LVEF decreased by 0.298%，LVEDD increased by 0.324 mm，and LVESD increased by 0.318 mm. Conclusion: Both HMGB1 and TNF-α increase with the progression of DKD，and HMGB1 has the greatest impact on the cardiac function of patients with DKD. HMGB1 may play an important role in the occurrence and development of cardiovascular events in patients with DKD. Early detection of HMGB1 can help reduce the occurrence of cardiovascular complications in patients with DKD.