المستخلص
Introduction: Diabetic nephropathy (DN) is a significant complication of diabetes and the leading cause of end-stage renal disease (ESRD). It causes structural and functional abnormalities in the glomerulus, leading to proteinuria and a glomerular hyperfiltration . The pathogenesis is complex, with hyperglycemia causing oxidative stress and inflammation. Targeting these factors is crucial for managing DN. Selenium can improve renal function in animal models.
Aim. The study aimed to evaluation of selenium and iron in serum of diabetic nephropathy patients and its relationship with inflammation (IL-6, hs-CRP) and oxidative stress biomarker (SOD, GSH-px), also this study included fasting blood sugar, urea, creatinine, albumin and lipid profile and its correlation with selenium and iron levels.
Material and methods: The study carried out in the Nephrology and Hemodialysis Unit of Baquba General Hospital’s Ibn Sina Dialysis Center and Gulanar private laboratory from period (October 20, 2023, until January 8, 2024). The study include (80 ) blood samples from patients with diabetic nephropathy and the control group who participated in this study include forty (40) apparently healthy person’s. They had various blood tests done, which included levels of serum glucose , urea , creatinine , lipids, iron, ferritin, inflamattory biomarker (C- reactive protein, IL-6) and oxidative stress ( glutathione peroxidase, and superoxide dismutase).
The selenium Microplate Assay Kit User Manual Detection and Quantification of Selenium Content in Urine, Serum, Plasma.
Iron were estimated by use (colorimetric methods) by Cobas C311 assay also another tests ( blood glucose, urea , creatinine , albumin and lipid profile ).
Glutathione peroxidase and superoxide dismutase were estimated by using the kit is a sandwich enzyme immunoassay for in vitro quantitative in human serum
,plasma ,tissue homogenates and other biological fluids. COBAS E411 plus
analyzer automatically applicate for serum and plasma, Pipetting reagents – working solution and steps of calculates the analyte activity of each sample for Interleukin -6.
The results of this study have been showed a significant difference between Mean of selenium levels in patients group as compared to control group, patients group ( 55.85 ± 9.68) ( 88.4375±11.2035 ) p- value ( t-test= 20.7 , DF=118 , P-
value <0.0001). there is a significant relationship, as the study indicated that there is a decrease in glutathione peroxidase (GSH-Px) levels when comparing groups of patients and healthy people ( 16.6929±2.3514 and 63.00±7.1702) respectively ( T-test= 3.499 , P = 0.0010 ). Superoxide dismutase had a significant decrease between patients and control group ( 121.4587±60.5242 and 315.0±55.8511) respectively ( T-test=2.87, P = 0.0062 ). The results definitively established a significant correlation between inflammatory markers in diabetic patients with diabetic nephropathy and the control group.
In iron a significant variable were detected in comparation between patients and control groups , mean and SD (39.4922±6.6343 , 76.9167±17.8310) respectively and p-value (P = 0.0195) . also when we compared between studied groups for ferritin ( 28.7447±39.1750 , 133.7143 ±64.9786 ) and p-value (P < 0.0001) .
The study found no significant correlation between selenium ,oxidative stress, GPX, and selenium, a measure of oxidative stress. However, selenium was found to have a significant positive association with IL-6, CRP, and albumin. There was no significant correlation between iron and oxidative stress, inflammatory markers, or albumin.
No significant correlation between lipid profile and glutathione peroxidase, cholesterol, TG, LDL, HDL, and VLDL. No significant correlation was found between lipid profile and selenium, cholesterol, TG, LDL, HDL, and VLDL.
Results showed high sensitivity in IL-6 in patients, while selenium was not detected in another test. The study examined serum iron and albumin levels in diabetic nephropathy patients and healthy control groups. Results showed high sensitivity in iron (65 p-value <0.001) and ferritin (81.2 p-value <0.001), and significant levels in albumin (96.6).
Conclusions: The study found that increasing age, particularly over 50 years, is a risk factor for diabetic nephropathy. Body mass index, particularly in obese individuals, was slightly associated with diabetic nephropathy. The incidence of diabetic kidney failure increased, especially in smokers and those with diabetes. our results showed the decline of of selenium levels in patients group as compared to control group .Diabetic patients showed a significant decrease in albumin levels, lipid variables, selenium levels, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD). There was a significant correlation between inflammatory markers and iron levels in diabetic patients with renal failure.
