Impaired intestinal barrier function in type 2 diabetic patients measured by serum LPS, Zonulin, and IFABP

J Diabetes Complications. 2021 Feb;35(2):107766. doi: 10.1016/j.jdiacomp.2020.107766. Epub 2020 Oct 23.

Abstract

Introduction: The epithelial tight junctions of intestine were impaired in murine model of type 2 diabetes mellitus (T2DM). The aim of this work was to investigate the alteration of intestinal barrier in T2DM patients.

Methods: 90 patients with T2DM and 28 healthy controls were recruited. Serum lipopolysaccharide (LPS), Zonulin, and intestinal fatty acid binding protein (IFABP) were measured by ELISA, based on which a derived permeability risk score (PRS) was calculated. Subgroup analyses were conducted based on the glycemic control (HbA1c < 7%, or HbA1c ≥ 7%), the amount of chronic diabetic complications, and the use of aspirin at the time.

Results: Serum LPS, Zonulin, and IFABP, and PRS of T2DM group were significantly higher than those of the control group (p < 0.05 for all). Serum LPS and PRS was higher in T2DM patients with poor glycemic control (both p < 0.05). Patients with more chronic complications of diabetes had higher serum LPS and IFABP, and PRS (all p < 0.05). No differences were found in these serum markers between T2DM patients being treated with aspirin or not.

Conclusions: Intestinal barrier function was impaired in T2DM patients. Poor glycemic control and more chronic complications of diabetes were associated with worse intestinal barrier function. Treatment with aspirin did not aggravate the impairment of intestinal barrier in T2DM patients.

Keywords: IFABP; Intestinal barrier function; LPS; Type 2 diabetes mellitus; Zonulin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aspirin / therapeutic use
  • Diabetes Mellitus, Type 2* / complications
  • Fatty Acid-Binding Proteins / blood*
  • Glycated Hemoglobin
  • Glycemic Control
  • Haptoglobins
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestinal Mucosa / physiopathology*
  • Lipopolysaccharides* / blood
  • Protein Precursors / blood*

Substances

  • Fatty Acid-Binding Proteins
  • Glycated Hemoglobin A
  • Haptoglobins
  • Lipopolysaccharides
  • Protein Precursors
  • zonulin
  • Aspirin