Background

This study aimed to investigate the relationship between lipopolysaccharide (LPS) and zonulin levels and also to show the effect of acute hyperglycemic stress induced by oral glucose tolerance testing (OGTT) on zonulin levels in pre-diabetic patients.

Methods

Four groups were constituted according to the criteria of the American Diabetes Association (ADA), based on OGTT results: control group (n:40); prediabetic group (n:56), divided into two subgroups: impaired fasting glucose group (IFG) (n:36), and impaired glucose tolerance (IGT) + IFG group (n:20) and type-2 diabetes mellitus (T2DM) group (n:45).

Results

Zonulin and LPS did not significantly differ between the prediabetes and control groups, but were significantly higher in the T2DM group compared to both the prediabetic and the control group (P < 0.001). After OGTT, zonulin and LPS were significantly higher in the prediabetes group compared to the control group (P < 0.01 and P < 0.05, respectively), and significantly lower in the IFG and IFG + IGT groups compared to the T2DM group (P < 0.001, P < 0.001 and P < 0.001, P < 0.001, respectively). A positive correlation was detected between fasting zonulin and 2-hour zonulin (r = 0.727, P < 0.001) and between fasting LPS (r = 0.555, P < 0.001) and 2-hour LPS (r = 0.567, P < 0.001) in the prediabetic group. Increased zonulin and LPS levels and the positive correlation between these levels during the prediabetic period although non significant suggests onset of intestinal permeability.

Conclusions

During acute hyperglycemia in prediabetic patients, up-regulation of zonulin and LPS may affect intestinal function. The intestines may play a key role in up-regulation of glucose and the pathogenesis of diabetes.

中文翻译：

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糖尿病前期患者血清zonulin水平的评价

背景

本研究旨在研究脂多糖 (LPS) 与 zonulin 水平之间的关系，并显示口服葡萄糖耐量试验 (OGTT) 诱导的急性高血糖应激对糖尿病前期患者的 zonulin 水平的影响。

方法

根据美国糖尿病协会 (ADA) 的标准，基于 OGTT 结果，分为四组：对照组（n：40）；糖尿病前期组（n：56），分为两个亚组：空腹血糖受损组（IFG）（n：36）、糖耐量减低（IGT）+IFG组（n：20）和2型糖尿病（T2DM）组 ( n :45)。

结果

Zonulin 和 LPS 在糖尿病前期和对照组之间没有显着差异，但与糖尿病前期和对照组相比，T2DM 组显着更高（P  <  0.001）。OGTT 后，糖尿病前期组 zonulin 和 LPS 显着高于对照组（P  <  0.01 和P  <  0.05），IFG 和 IFG  +  IGT 组显着低于T2DM 组（P  <  0.001 , P  <  0.001 和P  <  0.001, P  < 0.001，分别）。在空腹 zonulin 和 2 小时 zonulin (r  =  0.727, P  <  0.001) 之间以及空腹 LPS (r  =  0.555, P  <  0.001) 和 2 小时 LPS (r  =  0.567, P  <  0.001) 之间检测到正相关糖尿病前期组。在糖尿病前期，zonulin 和 LPS 水平升高以及这些水平之间的正相关性虽然不显着，但表明肠道通透性的开始。

结论

在糖尿病前期患者的急性高血糖期间，zonulin 和 LPS 的上调可能会影响肠道功能。肠道可能在葡萄糖的上调和糖尿病的发病机制中起关键作用。