The Effect of Metformin Therapy on Serum IL-33 and ST-2 Receptor Levels in Patients With Type 2 Diabetes Mellitus

Introduction: Patients with type 2 had elevated levels of inflammatory biomarkers, including interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF-α). Significant elevations in serum levels of TNF-α and C-reactive protein were seen in individuals with type 2 diabetes mellitus (T2DM). The IL-1 superfamily (IL-1β, IL-18, and IL-33) plays a crucial role in the development of diabetes mellitus by modifying immunological and inflammatory immune responses. Objectives: Little is known about the role of metformin in type 2 diabetes mellitus with respect to serum levels of IL-33 and ST-2 receptors. Therefore, in the present study, we sought toexplore such role. Patients and Methods: This single arm study included 45 type 2 diabetes patients with an age range of 30 to less than 60 years. Patients were given metformin (500 mg orally; for two months then, serum level of interleukin- 33 (IL-33) and ST-2 receptors were evaluated. Results: Treatment resulted in significant reduction of serum the suppression of tumorigenicity suppressor 2 (ST2) from 0.71 ±0.157 µg/mlto 0.59 ±0.11 µg/ml (p<0.001), across with significant increase in serum IL-33 from 0.60 ±0.18 pg/ml to 0.75 ±0.13 pg/ml (p < 0.001). Conclusion: Treatment of type 2 diabetes mellitus using metformin revealed a crucial role for IL-33 and ST-2 receptors in glycemic control since increment in IL-33 and reduction in ST-2 receptors were associated with good glycemic control suggesting an inflammatory role in disease pathogenesis and response to treatment.