Upregulation of Monocyte Chemoattractant Protein-1 (MCP-1) in Early Diabetic Nephropathy in Patients with Type-1 Diabetes Mellitus

Abstract

Background. Monocyte chemoattractant protein-1 (MCP-1) can directly elicit an inflammatory response by inducing cytokine and adhesion molecule expression in the kidney. We investigated the role of MCP-1 in the development of early nephropathy in patients with type-1 diabetes mellitus, in addition to the effect of high-dose vitamin E treatment (8 weeks) on early stages of diabetic nephropathy. Methods. This study was carried out on 30 type-1 diabetic patients subdivided into two equal groups according to their urinary albumin excretion, in addition to 10 healthy matched volunteers included as controls. MCP-1, glycated hemoglobin (HbA1c), and albuminuria—before and after vitamin E treatment—were measured in all studied groups. Results. Serum MCP-1 and HbA1c were significantly elevated in patients with microalbuminuria and poor glycemic control (941.67±47.03 pg/mL; 16.95±2.74%) compared to normoalbuminuric diabetic patients (622.73±103.23 pg/mL; 7.23±0.86%), and controls (366.60±129.01; 3.35±0.66) (P=.001), respectively. There was positive correlation between MCP-1 and HbA1c. Both MCP-1 and albuminuria decreased significantly after using high-dose vitamin E treatment, though there was no change in HbA1c in type-1 diabetic patients with early nephropathy. Conclusion. These observations suggest that MCP-1 may be involved in the pathogenesis of diabetic nephropathy. High-dose vitamin E may provide a novel form of therapy for the prevention of microvascular complications in type-1 diabetic patients.