Increased intestinal permeability as a risk factor for type 2 diabetes

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.