Unravelling interplay of serum MMP-7 and TGF- β in diabetic nephropathy - A study from a tertiary centre in eastern India.

Abstract

Diabetic Nephropathy (DN) constitutes nearly half of cases of end stage renal disease. Despite decrease in kidney function, eGFR in the early stages may remain unaltered, making diagnosis difficult pointing towards need of more accurate biomarkers for early detection. Altered serum Matrix Metallo-Proteinase-7 (MMP-7) and transforming growth factor- β (TGF-β) has been noted independently in diabetic complications. The role of MMP-7 with TGF-β together has been highlighted in extracellular matrix remodelling in kidneys of diabetic rats. Interaction between MMP-7 with TGF- β in DN cases is scarce. Hence, the objective of present study is to evaluate role of serum MMP-7 and TGF-β in DN. This case control Study included 61 DN cases, 61 diabetes Mellitus controls and 61 healthy controls. After clinical evaluation routine biochemical parameters were estimated along with serum MMP-7 and TGF-β. They were analysed in relation to glycemia and eGFR along with correlation analysis. Serum MMP-7 and TGF-β registered significant rise (<i>P</i> value-<0.001) in DN cases in comparison to control groups. Their substantial association with each other and with glycaemic status and renal function was noted in the correlational analysis. Diagnostic accuracy of MMP-7 and TGF-β for DN was also noted with significant sensitivity and specificity. Multiple regression analysis documented MMP-7 as an independent determinant for Diabetic nephropathy. Serum MMP-7 along with TGF-β play significant role in the pathogenesis of DN. Prospective longitudinal study with future Genetic analysis for their expression is needed to establish their role in disease diagnosis and progression.