Publicado

2023-07-01

Analysis of confounding caused by creatinine and age in the correlation between soluble tumor necrosis factor α receptor 1 (sTNFR1) levels and estimated glomerular filtration rate (eGFR) in Colombian patients with type 2 diabetes

Análisis de la confusión producida por la creatinina y la edad en la correlación entre los niveles del receptor soluble 1 del factor de necrosis tumoral α (sTNFR1) y la tasa de filtración glomerular estimada (TFGe) en pacientes colombianos con diabetes mellitus tipo 2

Palabras clave:

Diabetes Mellitus, Type 2, Diabetic nephropathy, Receptors, Tumor Necrosis Factor, Linear Regression (en)
Diabetes Mellitus tipo 2, Nefropatía, Receptores del Factor de Necrosis Tumoral, Regresión Lineal (es)

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Autores/as

  • Alejandro Poveda Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina - Laboratorio de Lípidos y Diabetes - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-6454-4678
  • Nicolás Gómez-Banoy Weill Center for Metabolic Health - Instituto de Investigación Cardiovascular - División de Cardiología - Departamento de Medicina - Weill Cornell Medicine - Nueva York - Estados Unidos. https://orcid.org/0000-0002-3552-1768
  • Ismena Mockus Universidad Nacional de Colombia - Sede Bogotá - Facultad de Medicina - Laboratorio de Lípidos y Diabetes - Bogotá D.C. - Colombia. https://orcid.org/0000-0003-2312-5327

Introduction. Tumor necrosis factor α (TNF-α) is a cytokine involved in inflammatory processes associated with type 2 diabetes mellitus (DM2). Although the correlation between soluble TNF-α receptor 1 (sTNFR1) levels and estimated glomerular filtration rate (eGFR) has been already described in Colombian population with DM2, the influence of sTNFR1 on eGFR in a model adjusted for age and creatinine level has not yet been evaluated.

Objectives. To identify and evaluate the linear correlations between sTNFR1 levels, routine clinical variables, and eGFR in Colombian patients with DM2.

Materials and methods. Cross-sectional study conducted in March 2020 in 69 patients with DM2 who were enrolled in the Program for the Prevention of Diabetes Complications and Dyslipidemias of the Faculty of Medicine of the Universidad Nacional de Colombia. Medical records were reviewed in order to obtain sociodemographic, anthropometric and clinical data. Serum sTNFR1 levels were determined by means of an ELISA test. A multiple linear regression model (stepwise regression) was performed to evaluate correlations between sTNFR1, clinical variables, and eGFR.

Results. The final multiple linear regression model, which includes creatinine levels, sTNFR1 levels, and age, explained 72% of the variance of eGFR (p=0.023). Furthermore, sTNFR1 levels explained 20% of the variance of eGFR independently (standardized β coefficient: -0.2; 95%CI: [-0.008]-[-0.001]; p=0.02).

Conclusion. In the final multiple linear regression model, an inversely proportional and statistically significant linear correlation was found between sTNFR1 levels and eGFR, independent of serum creatinine levels and age. Compared with age, sTNFR1 levels have a superior effect in terms of changes in eGFR.

Introducción. El factor de necrosis tumoral α (TNF-α) es una citoquina involucrada en los procesos inflamatorios de la diabetes mellitus tipo 2 (DM2). Aunque la correlación entre los niveles del receptor soluble 1 del TNF-α (sTNFR1) y la tasa de filtración glomerular estimada (TFGe) ya ha sido descrita previamente en población colombiana con DM2, la influencia del sTNFR1 en la TFGe en un modelo ajustado a edad y creatinina no ha sido evaluada.

Objetivos. Identificar y evaluar las correlaciones lineales entre los niveles del sTNFR1, las variables clínicas de uso rutinario y la TFGe en pacientes colombianos con DM2.

Materiales y métodos. Estudio transversal realizado en marzo de 2020 en 69 pacientes con DM2 que estaban inscritos en el Programa para la prevención de las complicaciones de la diabetes y las dislipidemias de la Facultad de Medicina de la Universidad Nacional de Colombia. Los datos sociodemográficos, antropométricos y clínicos se recolectaron a partir de la revisión de las historias clínicas. Los niveles séricos del sTNFR1 se determinaron mediante prueba de ELISA. Se realizó un modelo de regresión lineal múltiple (regresión paso a paso) para evaluar las correlaciones entre el sTNFR1, las variables clínicas y la TFGe.

Resultados. El modelo final de regresión lineal múltiple, que incluye niveles de creatinina, niveles del sTNFR1 y edad, explica el 72% de la varianza de la TFGe (p=0.023); además, los niveles del sTNFR1 explican el 20% de la varianza de la TFGe de forma independiente (coeficiente β estandarizado: -0.2; IC95%: [-0.008]-[-0.001]; p=0.02).

Conclusión. En el modelo final de regresión lineal múltiple se encontró una correlación lineal inversamente proporcional y estadísticamente significativa entre los niveles del sTNFR1 y la TFGe, independientemente de los niveles séricos de creatinina y la edad. Comparado con la edad, los niveles del sTNFR1 tienen un efecto superior en términos de cambios en la TFGe.

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