Increased Levels of Soluble Tnf-R1 and Serum Amyloid a in Patients With Diabetic Nephropathy Publisher



Freidoon M ; Assadiasl S ; Kazemzadehghadim H ; Sayadi N ; Soleimanifar N ; Safdel S ; Sadr M ; Mojtahedi H ; Chezanisharahi P ; Nicknam MH
Source: International Journal of Diabetes in Developing Countries Published:2026

Abstract

Background: Diabetic nephropathy is a common complication of uncontrolled hyperglycemia in diabetic patients, usually leading to renal failure. Therefore, establishing rapid, easy-to-use diagnostic biomarkers is essential for effective monitoring of patients. Serum cytokine levels might be a potential option for this purpose. Objectives: In this study, we aimed to compare the serum levels of soluble TNF Receptor 1 (sTNF-R1), Transforming Growth Factor beta (TGF-β), and amyloid A (SAA) between patients without nephropathy and healthy individuals, and to assess their associations with clinical indices. Methods: The serum levels of sTNF-R1, TGF-β, and SAA were measured by ELISA in 60 patients with DN, 60 diabetic patients without nephropathy, and 60 healthy individuals, in association with clinical findings. Results: sTNF-R1 was elevated in DN patients compared to the healthy subjects (p-value 0.002). SAA levels were significantly different between the three groups, with the highest amounts in DN. However, TGF-β levels were comparable across groups. SAA showed a significant correlation with clinical findings including creatinine levels (p-value 0.007), estimated glomerular filtration rate (eGFR) (p-value 0.004), and urine albumin-creatinine ratio (UACR) (p-value 0.07) with AUC of 0.85. Conclusion: Serum levels of sTNF-R1 and amyloid A increased in patients with diabetic nephropathy and showed a correlation with clinical findings. TNF-R1 did not show a significant elevation in diabetic patients without nephropathy, suggesting it as a potential biomarker for established disease. In contrast, SAA levels were elevated in both patient groups compared to healthy controls, demonstrating a higher prognostic value for clinical and subclinical diabetic nephropathy. Moreover, TGF-β was neither elevated nor correlated with renal function in DN patients. © The Author(s), under exclusive licence to Research Society for Study of Diabetes in India 2026.