Document Type : Original Article


1 Clinic of Endocrinology, University Hospital “Alexandrovska”, Department of Internal Medicine, Medical University-Sofia, Bulgaria

2 Clinical Laboratory and Clinical Pharmacology, University Hospital “Alexandrovska”, Department of Clinical Laboratory, Medical University-Sofia, Bulgaria

3 Department of Psychoimmunology, Hyogo College of Medicine, Japan


Background: Obesity and diabetes are related to a chronic low-grade inflammation. As a pro-inflammatory cytokine, IL-18 stimulates various cell types and has pleiotropic functions. Objective: To assess the levels of IL-18 in subjects from the entire spectrum of glycemic disorders. Methods: This study included 387 Caucasians divided into four groups: healthy controls, obese subjects without carbohydrate issues, prediabetic patients, and recently discovered type 2 diabetics. Results: Subject with body mass index ≥30kg/m2 and glycemic disorders showed significantly higher levels of IL-18 (249.77 ± 89.96 pg/ml; 259.01 ± 95.70 pg/ml; and 340.98 ± 127.65 pg/ml) compared with that of the control group (219.47 ± 110.53 pg/ml, p < 0.05). IL-18 also had significant positive associations with some anthropometric parameters, liver enzymes, fasting, post-load glucose, insulin, uric acid, and triglycerides while negative with HDL. The circulating IL-18 levels for differentiating subjects with carbohydrate disturbances and those with metabolic syndrome were determined by ROC analysis. The AUC for the disturbances of the carbohydrate metabolism was 0.597 (p = 0.001; 95% CI = 0.539 - 0.654) and for MS AUC was 0.581 (p = 0.021; 95 % CI = 0.516 - 0.647). Conclusion: Our data indicate that as the levels of IL-18 are increased the carbohydrate tolerance is deteriorated. However, the significance of IL-18 in the progression of diabetes mellitus and subsequent consequences requires further exploration.