期刊
CLINICAL NUTRITION
卷 38, 期 2, 页码 529-538出版社
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.clnu.2018.03.016
关键词
CORDIOPREV; Endotoxemia; Inflammation; Prediction model; Diabetes
资金
- Fundacion Patrimonio Comunal Olivarero
- Junta de Andalucia (Consejeria de Salud)
- Junta de Andalucia (Consejeria de Agricultura y Pesca)
- Junta de Andalucia (Consejeria de Innovacion, Ciencia y Empresa)
- Diputaciones de Jaen y Cordoba
- Centro de Excelencia en Investigacion sobre Aceite de Oliva y Salud
- Ministerio de Medio Ambiente, Medio Rural y Marino, Gobierno de Espana
- Ministerio de Economia y Competitividad [AGL2012/39615, PIE14/00005, PIE 14/00031, AGL2015-67896-P, CP14/00114, FIS PI13/00023, PI13/00619, BFU2016-76711-R]
- Consejeria de Innovacion, Ciencia y Empresa, Proyectos de Investigacion de Excelencia, Junta de Andalucia [CVI-7450]
- Fondo Europeo de Desarrollo Regional (FEDER)
- ISCIII research contract (Programa Miguel-Servet) [CP14/00114]
Background & aims: Insulin resistance (IR) and impaired beta-cell function are key determinants of type 2 diabetes mellitus (T2DM). Intestinal absorption of bacterial components activates the toll-like receptors inducing inflammation, and this in turn IR. We evaluated the role of endotoxemia in promoting inflammation-induced insulin resistance (IR) in the development of T2DM, and its usefulness as predictive biomarker. Methods: We included in this study 462 patients from the CORDIOPREV study without T2DM at baseline. Of these, 107 patients developed T2DM according to the American Diabetes Association (ADA) diagnosis criteria after a median follow-up of 60 months (Incident-DIAB group), whereas 355 patients did not developed it during this period of time (Non-DIAB group). Results: We observed a postprandial increase in lipopolysaccharides (LPS) levels in the Incident-DIAB at baseline (P < 0.001), whereas LPS levels were not modified in the Non-DIAB. Disease-free survival curves based on the LPS postprandial fold change improved T2DM Risk Assessment as compared with the previously described FINDRISC score (hazard ratio of 2.076, 95% CI 1.149-3.750 vs. 1.384, 95% CI 0.740 -2.589). Moreover, disease-free survival curves combining the LPS postprandial fold change and FIN-DRISC score together showed a hazard ratio of 3.835 (95% CI 1.323-11.114), linked to high values of both parameters. Conclusion: Our results suggest that a high postprandial endotoxemia precedes the development of T2DM. Our results also showed the potential use of LPS plasma levels as a biomarker predictor of T2DM development. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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