Interleukin-18 as a Promising Noninvasive Marker for Esophageal Varices: Correlation to Hepatic Dysfunction

Abstract

Background: Noninvasive screening methods for esophageal varices (EVs) are beneficial to avoid unnecessary esophagogastroduodenoscopy (EGD). This study aimed to determine serum IL-18 levels in liver cirrhosis patients and to assess the association of serum IL-18 levels with EVs. Method: Case-control research including 54 cirrhotic patients brought on by hepatitis C virus infection and 18 healthy controls. All subjects were subjected to a thorough physical examination, a history assessment, and a set of laboratory tests, including those for alpha-fetoprotein, hepatitis markers, liver function and serum IL-18. Result: Serum IL-18 was significantly higher in patients with cirrhosis compared with the normal control, as well as in patients with cirrhosis with EVs than in patients without EVs. No significance detected between patients with cirrhosis with and without bleeding EVs. IL-18 was positively correlated with serum bilirubin level, portal vein diameter, spleen diameter, Child-Pugh, and Model for End-Stage Liver Disease scores and negatively correlated with serum albumin, PV velocity, and platelet count. Additionally, IL-18 was significantly correlated with noninvasive scores of liver fibrosis and PH. The univariate logistic regression revealed IL-18, Child-Pugh score, platelet count, serum albumin, PV diameter, SD, and platelet count/SD ratio as potential EV predictors. Conclusion:IL-18 yields a significant clinical value for liver cirrhosis and EV development. A cut-off value of >428 pg/ml can predict EV in liver cirrhosis with 66.67% sensitivity and 94.44% specificity but without an apparent role in variceal bleeding prediction.