Increased intestinal permeability as a risk factor for type 2 diabetes

Diabetes Metab. 2017 Apr;43(2):163-166. doi: 10.1016/j.diabet.2016.09.004. Epub 2016 Oct 10.

Abstract

Aim: Relationships between the intestinal microbiota, intestinal permeability and inflammation in the context of risk for obesity-associated disease continue to be of interest. The aim of the study was to examine the associations between intestinal permeability and type 2 diabetes (T2D).

Methods: A total of 130 individuals with T2D (age: 57.5±6.2 years (mean±SD); BMI: 30.4±3.2; 45% female) and 161 individuals without T2D (age: 37.4±12.5 years; BMI: 25.1±3.9; 65% female) were included in the study. Assessment of intestinal permeability included measurement of circulating lipopolysaccharide (LPS), LPS-binding protein (LBP) and intestinal fatty acid binding protein (iFABP) concentrations, which were used for calculation of a derived permeability risk score (PRS). Associations between permeability measures and T2D status were assessed using logistic regression models.

Results: LBP (∼34%, P<0.001), iFABP (∼46%, P<0.001) and the PRS (∼24% P<0.001) were all significantly higher in the T2D affected individuals. Individuals with a PRS in the upper tertile were 5.07 times more likely (CI: 1.72-14.95; P=0.003) to have T2D when models were adjusted for age, sex and BMI. There was a trend towards improved prediction when including the PRS in models containing age, sex and BMI (AUC: 0.954 versus 0.962; P=0.06).

Conclusion: These data demonstrate differences in measures of intestinal permeability between individuals with and without T2D. The utility of using intestinal permeability measures as a tool for predicting T2D risk in at risk individuals should be further investigated.

Keywords: Diabetes; Inflammation; Intestinal permeability; Prediction.

MeSH terms

  • Acute-Phase Proteins
  • Adolescent
  • Adult
  • Aged
  • Blood Pressure / physiology
  • Carrier Proteins / blood*
  • Diabetes Mellitus, Type 2
  • Fatty Acid-Binding Proteins / blood*
  • Female
  • Humans
  • Intestinal Mucosa / metabolism*
  • Lipopolysaccharides / blood*
  • Male
  • Membrane Glycoproteins / blood*
  • Middle Aged
  • Permeability
  • Risk Factors
  • Young Adult

Substances

  • Acute-Phase Proteins
  • Carrier Proteins
  • Fatty Acid-Binding Proteins
  • Lipopolysaccharides
  • Membrane Glycoproteins
  • lipopolysaccharide-binding protein