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Rheumatology Advance Access originally published online on March 9, 2006
Rheumatology 2006 45(9):1148-1153; doi:10.1093/rheumatology/kel082
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Relationship of plasma interleukin-18 concentrations to traditional and non-traditional cardiovascular risk factors in patients with systemic lupus erythematosus

Tim K. Tso1,, Wen-Nan Huang2, Hui-Yu Huang1 and Chen-Kang Chang3

1Graduate Institute of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei, 2Department of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung and 3Sport Science Research Center and Department of Sport Management, National Taiwan College of Physical Education, Taichung, Taiwan.

Correspondence to: Tim K. Tso, Graduate Institute of Food Science, Nutrition and Nutraceutical Biotechnology, Shih Chien University, 70 Ta-Chih Street, Taipei104, Taiwan. E-mail: timtso{at}mail.usc.edu.tw

Objectives. Systemic lupus erythematosus (SLE) is associated with premature atherosclerosis. Recent studies indicated that the concentrations of circulating interleukin (IL)-18, a novel proinflammatory T helper-1 cytokine, in SLE patients were significantly higher than those in healthy control subjects. The objective of this study was to examine the relationship between IL-18 and cardiovascular risk factors in patients with SLE.

Methods. Both traditional and non-traditional cardiovascular risk factors including body mass index (BMI), systolic blood pressure, diastolic blood pressure (DBP), fasting insulin and glucose, plasma lipid profile, plasma homocysteine, thiobarbituric acid-reactive substances, titres of autoantibodies against oxidized low-density lipoprotein, and brachial–ankle pulse wave velocity (baPWV) were determined in a total of 72 female SLE patients. All patients were further classified into subgroups based on tertiles of plasma IL-18 concentrations.

Results. Plasma concentrations of IL-18 were significantly higher in SLE patients than age-matched healthy controls. SLE patients with IL-18 concentration in the top tertile compared with the bottom tertile had significantly higher plasma levels of insulin, triglyceride, homocysteine and values of homeostasis model assessment insulin resistance (HOMA IR) and HOMA ß-cell. In addition, plasma concentrations of IL-18 correlated positively and significantly with BMI, insulin, HOMA IR, HOMA ß-cell, triglyceride, homocysteine, DBP and baPWV in all SLE patients.

Conclusions. This is th first report showing the relationship between IL-18 and cardiovascular risk factors in SLE. In patients with SLE, the synergistic effects of hyperinsulinaemia, insulin resistance, hyperhomocysteinaemia, and vascular stiffness most likely contribute to the elevation of plasma IL-18 concentrations.

KEY WORDS: Brachial–ankle pulse wave velocity, Cardiovascular risk, Homocysteine, Insulin, Interleukin-18, Systemic lupus erythematosus.


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