الفهرس 
Introduction and RationaleOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus (DM) is a group of metabolic diseases characterized by chronic hyperglycemia occurs either because of a lack of insulin or because of the presence of factors that oppose the action of insulin. The result of insufficient action of insulin is an increase in blood glucose concentration (hyperglycemia).
Vascular complications occuras a result of chronic elevation of blood glucose levels, which leads to damage of blood vessels. Generally, the injurious effects of hyperglycemia are separated into macrovascular complications (coronary artery disease, peripheral arterial disease, and stroke) and microvascular complications (DN, neuropathy, and retinopathy).
Diabetic nephropathy is a chronic kidney disease due to microvascular complication of DM. It is defined by low degrees of proteinuria, or microalbuminuria which defined as albumin excretion of 30–299 mg/24 hours.
Tumor Necrosis Factor-α is a multifunctional pro-inflammatory cytokine which is associated with some pathological processes such as apoptosis, proliferation, inflammation and immunoregulation.TNF-α produced by T cell and macrophages also produced by multiple cells in kidney itself. Among which GMC plays a cru¬cial role in the progression of DN and the func¬tion change of GMC increases the risk of DN.
Tumor Necrosis Factor-α gene locus is located within the Class III region of MHC on chromosome 6, it’s a highly polymorphic locus. Several SNPs have been identified in the human TNF-α˛ gene promoter region especially (-308G/A), having the potential to cause structural changes within regulatory sites that could affect the function or regulation of TNF-α production.
The current study aimed to illustrate the association between TNF α polymorphism, and DN.The study included 50 diabetic patients divided into two groups; diabetic patients with nephropathy (n=25) and diabetic patients without nephropathy (n=25). DM diagnosis based on the clinical and laboratory criteria proposed by the American Diabetes Association for diagnosis and classification of DM. DN diagnosis based on the laboratory criteria proposed by American family physician A third group of apparently healthy blood donors (n=25) served as a normal control group.
Tumor Necrosis Factor-α SNP polymorphism was performed by RFLP.
Among participants, presence of A allele is positively correlated with occurrence of DN.
According to study results, carrying A allele (GA+AA) appears to have a predictive value to developing DN.
Study Limitations:
The relatively small sample size due to high cost of the lab investigations and the lack of institutional financial support is a big concern in this study.