ArticleFrontiers in immunology2026
IL-1β/IL-1Ra ratio dysregulation in islet autoantibody-positive adult-onset diabetes.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The IL-1 pathway plays a central role in β-cell dysfunction; however, the relationship between IL-1β/IL-1Ra imbalance and islet autoimmunity in newly diagnosed adult-onset diabetes remains insufficiently defined. This study aimed to evaluate whether dysregulation of the IL-1β/IL-1Ra ratio differs according to islet autoantibody status. Methods: This cross-sectional study included 240 adults with newly diagnosed adult-onset diabetes recruited from primary healthcare facilities. Serum IL-1β and IL-1Ra concentrations were measured using enzyme-linked immunosorbent assays, and the IL-1β/IL-1Ra ratio was calculated as an index of inflammatory regulation. Islet autoantibodies to glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 (IA-2A), zinc transporter 8 (ZnT8A), and islet cells (ICA) were determined using standardized ELISA assays. Associations were evaluated using nonparametric tests, multivariate logistic regression, and receiver operating characteristic (ROC) analysis. Results: Circulating IL-1β concentrations did not differ between autoantibody-positive and autoantibody-negative individuals. In contrast, IL-1Ra levels were significantly lower in autoantibody-positive patients (p = 0.029). Consequently, the IL-1β/IL-1Ra ratio was significantly higher in autoantibody-positive individuals compared with autoantibody-negative patients (p = 0.030). Among autoantibody-positive participants, the IL-1β/IL-1Ra ratio was significantly higher in individuals with single autoantibody positivity compared to those with multiple autoantibodies (p = 0.018), indicating a non-linear relationship between autoimmune burden and inflammatory imbalance. In multivariate analysis, a higher IL-1β/IL-1Ra ratio (OR 1.94, 95% CI 1.10-3.44; p = 0.024) and lower basal C-peptide levels (OR 0.50, 95% CI 0.33-0.76; p = 0.001) were independently associated with autoantibody positivity. ROC analysis demonstrated modest but statistically significant discriminative performance of the IL-1β/IL-1Ra ratio (AUC = 0.59, p = 0.030). Conclusion: Dysregulation of the IL-1β/IL-1Ra ratio is evident at the time of diabetes diagnosis and varies according to islet autoantibody status. The observed non-linear pattern, with a higher ratio in single autoantibody positivity, suggests stage-dependent inflammatory regulation and supports the concept of immunometabolic heterogeneity in adult-onset diabetes. While the IL-1β/IL-1Ra ratio reflects early inflammatory imbalance, its clinical utility as a standalone biomarker appears limited.
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