Dr. Christian Herder of Heinrich Heine University, Dusseldorf, and colleagues point out that this receptor antagonist has been shown to improve beta-cell function and glycemic control in patients with Type 2 diabetes. However, the relationship between baseline levels and diabetes onset had not been explored.

To do so, the researchers measured serum IL-1Ra concentrations in 181 patients and 376 matched normoglycemic controls who were followed for more than 10 years. All were participants in the Whitehall II cohort of more than 10,000 UK civil servants.

IL-1Ra concentrations at baseline were significantly higher in all cases than controls (median 232.8 pg/mL versus 207.6 pg/mL) and were significantly associated with incident Type 2 diabetes. The odds ratio was 1.48 per 1 SD increase in IL-1Ra. This remained the case after adjusting for potential confounders including age and cardiovascular risk factors.

However, adjustment for 2-hour glucose attenuated the association. This suggests, say the investigators, that "increased IL-1Ra levels are a reaction to and not a cause of early postprandial hyperglycemia before the onset of diabetes."

Commenting on the findings, Dr. Herder told Reuters Health that "It seems as if the body attempts to counterregulate proinflammatory disturbances before the onset of disease by an upregulation of antiinflammatory markers, but eventually fails."

"It remains to be seen," he concluded, "whether additional stimulation of this antiinflammatory response can help to prevent or delay the onset of Type 2 diabetes."

Diabetes Care 2009;32:421-423.