Abstract: Objective To investigate the effects of serum macrophage migration inhibitory factor (MIF) , tumor necrosis factor-alpha(TNF-alpha)on diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods According to urinary albumin excretion rate (UAER),97 patients with T2DM were divided into normal albuminuria (group A, n=31), microalbuminuria group (group B,n=35), and macroalbuminuria group (group C, n=31), thirty healthy persons were included as control group (group D). The serum levels of MIF and TNF-a were tested by ELLSA technique. Results Concentration of serum MIF in group A, group B and group C was significantly higher than those in control group (P<0.05). Concentration of serum MIF in group A, group B and group C was not significantly different (P>0.05). Concentration of serum TNF-a in group B and group C was significantly higher than those in control group (P<0.05). Concentration of serum TNF-a in group B and group C were significantly higher than that in group A. Spearman correlation analysis showed that concentration of serum MIF was positively correlated with HbA1c(r=0.459,P<0.01), FBG(r=0.520,P<0.01), TG(r=0.256, P<0.05), course of disease(r=0.435, P<0.01) and was negatively correlated with HDL-C(r=-0.244,P<0.05). Concentration of serum TNF-alpha was positively correlated with UAER(r=0.254,P<0.01) and course of disease(r=0.182,P<0.05). After adjusting for age ,duration of diabetes mellitus, systolic blood pressure, body mass index, LDL cholesterol logistic regression, it was found that concentration of serum TNF-alpha was related with albuminuria. But no correlation was found with serum MIF and albuminuria. Conclusion Alteration of serum TNF-alpha may be more sensitive than serum MIF on the pathogenesis of DN in patients with T2DM. Detection of serum TNF-alpha alone or with serum MIF together may be useful to reflect the degree of renal damage in diabetic nephropathy. High Concentrations of serum MIF and TNF are risk factors that might promote the deterioration of renal function in T2DM patients with DN.

Key words: type 2 diabetes mellitus, diabetic nephropathy, macrophage migration inhibitory factor, tumor necrosis factor alpha