الفهرس 
Urinary tumor necrosis factor alpha as an early marker for diabetic nephropathy in children and adolescents with type 1 diabetes
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Abstract
Introduction: Diabetic nephropathy (DN) is a major cause of morbidity and mortality among type 1 diabetes mellitus (T1DM). Albuminuria measurement is used as a standardized, noninvasive test to diagnose early DN; however, DN is not detected by this test in some cases. Our study was aimed to evaluate urinary tumor necrosis factor alpha (TNFÜ) as an early marker for DN in children and adolescents with T1DM. Subjects and methods: This cross-sectional study was carried out on 50 children and adolescent with T1DM > 5 years, with age range (8-18 years), they were divided into two groups according to albumin creatinine ratio (ACR), group I: ACR < 30 mg/g (n=25); group II: ACR 30-300 mg/g (n=25); group III: healthy control with no diabetes (n=25). Urinary TNFÜ was measured in patients and controls as well as other parameters. Results: There was significantly higher systolic and diastolic blood pressure in group II than group I (p=0.049&0.029, respectively), the laboratory data among the two patient groups are showed no significant difference; except the mean level of fasting plasma glucose was significantly higher in group II than group I (p=0.032). Urinary TNFÜ was not statistically different between all cases and controls or between the two patient groups. Also, there was no significant correlation between urinary TNF Ü among the two patient groups and clinical & laboratory data. Conclusion: our results provide evidence that hypertension was more frequent in microalbuminuric group, longer duration of diabetes and poor glycemic control are associated with increased risk of developing DN. Urinary TNFÜ was not significantly different between microalbuminuric and normoalbuminuric groups