Figure 5.

Obesity reduces the production of adiponectin in favor of leptin. Gene transcription of inflammatory mediators such as IL-1, IL-6, IL-7, IL-8, and TNF-α is increased, which creates a proinflammatory state and oxidative stress. Profibrotic factors plasminogen activator inhibitor-1 (PAI-1) and TGF-β1, connective tissue growth factor, and extracellular matrix proteins are increased, all contributing to progressive diabetic nephropathy. IL, interleukin; TNF-α, tumor necrosis factor-α; MCP-1, monocyte chemoattractant protein-1.