To investigate the changes and significance of interleukin-18(IL-18) and adiponectin in type 2 diabetic patients with nephropathy. Methods:This study included 96 patients with type 2 diabetes mellitus，These patients were divided into three groups according to the urinary albumin excretion rate(UAER) : normalalbuminuria group，micro-albuminuria group and macro-albuminuria ,and 35 healthy subjects as control group .Serum adiponectin and IL-18 was measured by enzyme linked immunosorbent assay(ELISA), Compare the differences of the groups. Results:Serum IL-18 levels in the diabetic patients were significantly higher than those in controls (P<0.05). Serum adiponectin levels in the normalalbuminuria group lower than in control's, micro-albuminuria group and macro-albuminuria higher than in control's(P<0.01),and increased with UAER.Serum IL-18 concentrations were significantly positively correlated with duration of DM. SBP、HbA1c、FPG、TG、TC、LDL-C、BUN、Scr and UAER levels (P<0.01) and significantly inversely correlated with HDL-C, were not obviously correlated with other indicator. adiponectin concentrations were significantly positively correlated with duration of DM. SBP、BUN、Scr and UAER levels (P<0.01). Conclusion:IL-18 and adiponectin may be involved in the development of type 2 diabetic nephropathy, combined detection of both have important role in early diagnosis and clinical treatment monitoring.