Correlation of Chemerin with some Immunological Parameters in Type II Diabetes Mellitus Patients on Hemodialysis in Ramadi General Hospital

Abstract

Diseases of kidney are among the most important causes of death in many countries. The major causes of chronic kidney disease include diabetes mellitus and chronic hypertension. This study was designed to evaluate some hematological and inflammation aspects in 95 patients, divided into (35) hemodialysis patients with diabetes, (35) hemodialysis patients without diabetes and (25) diabetes patients, and who attended at Ramadi General Hospital, in addition to (25) samples as control subject. Chemerin, Interleukin-18 (IL-18) and high sensitive C-reactive protein (hs-CRP) were established by ELISA. The results showed serum chemerin, interleukin-18 and hs-CRP were significantly higher in HD patients with diabetes (230.13±78.26 ng/ml at P=0.034, 677.23±99.14 pg/mL at P=0.026, and 15.77±2mg/L at P=0.048), respectively compared with control (110±20.42ng/ml, 143.68±35.78pg/mL, and 4.64±1.27mg/L), respectively. The results showed the significant and positive correlations between chemerin and hs-CRP or chemerin and IL-18 (r=0.149 at P=0.004 or r=0.123 at P=0.0325 in control), (r=0.165 at P=0.007 or r =0.190 at P=0.024 in diabetic patients), (r=0. 237 at P=0.0036 or r =0.263 at P= 0.038 in HD patients with diabetic) and (r=0. 0.235 at P = 0.0081or r=0.248 at P = 0.041in HD patients without diabetic) respectively. The mean of hemoglobin (Hb), Packed Cells Volume (PCV), Red Blood cells (RBC), White Blood Cells (WBC) and Lymphocytes were significantly decreased in HD patients without diabetes (8.55±0.63g/L (at p=0.0423), 27.63±1.31%(at p=0.028), 3.12±0.56 ˟10P 12 P\ L (at p=0.035), 6.7±0.53 ˟10P 9 P/L (at p=0.021) and 30.23±5.84%(at p= 0.046), respectively compared with control. The mean of Monocytes% (17.23±7.28% at p=0.031) and Granulocyte% (59.31±9.45 % at p=0.042) were significantly higher in HD patients with diabetes, while mean of Mononocytes% was significant lower in diabetic patients. This study suggests a significant role of chemerin, hs-CRP and IL-18 in the pathogenesis and progression of diabetic complications, and we can use these parameters for predicting the progression of diabetic nephropathy in the early stages of CKD.