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High Serum Concentration of Interleukin-18 in Diabetic Patients with Foot Ulcers

Tevfik Sabuncu Department of Endocrinology, Harran University Faculty of Medicine, Sanliurfa, Turkey.

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Mehmet Ali Eren Department of Endocrinology, Harran University Faculty of Medicine, Sanliurfa, Turkey.

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Suzan Tabur Department of Endocrinology, Harran University Faculty of Medicine, Sanliurfa, Turkey.

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Omer Faruk Dag Department of Internal Medicine, Harran University Faculty of Medicine, Sanliurfa, Turkey.

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Omer Boduroglu Department of Internal Medicine, Harran University Faculty of Medicine, Sanliurfa, Turkey.

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Background

It is well known that interleukin-18 (IL-18) plays a key role in the inflammatory process. However, there are limited data on the role IL-18 plays with diabetic foot ulcers, an acute and complex inflammatory situation. Therefore, we aimed to evaluate serum IL-18 levels of diabetic patients with foot ulcers.

Methods

Twenty diabetic patients with acute foot ulcers, 21 diabetic patients without a history of foot ulcers, and 21 healthy volunteers were enrolled in our study. Circulating levels of IL-18, and other biochemical markers are parameters of inflammation and were measured in all three groups.

Results

Diabetic patients both with and without foot ulcers had high IL-18 concentrations (P < 0.001 and P = 0.020, respectively) when compared with the nondiabetic volunteers. Those with foot ulcers had higher levels of IL-18 level (P < 0.001), high-sensitivity C-reactive protein (hsCRP) (P = 0.001), and erythrocyte sedimentation rate (ESR) (P < 0.001) than those without foot ulcers.

Conclusions

We found that serum IL-18 concentrations were elevated in diabetic patients with acute diabetic foot ulcers. However, these findings do not indicate whether the IL-18 elevation is a cause or a result of the diabetic foot ulceration. Further studies are needed to show the role of IL-18 in the course of these ulcers.

Corresponding author: Mehmet Ali Eren, MD, Department of Endocrinology, Harran University Faculty of Medicine, Yenisehir Campus, Sanliurfa, Turkey, 63300. (E-mail: drmalieren@hotmail.com)