Metabolic Endotoxemia and Diabetes Mellitus : a Systematic Review

Metabolic Endotoxemia and Diabetes Mellitus : a Systematic Review

Abstract In this systematic review we analyzed studies that assessed serum concentrations of lipopolysaccharide (LPS) and/or lipopolysacharide-binding protein (LBP) in diabetic patients compared with healthy people. Articles were selected using PubMed and Scopus. Search terms used were endotoxemia,...

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Bibliographic Details
Published in:Metabolism, clinical and experimental Vol. 68; pp. 133 - 144
Main Authors: Gomes, J.M.G, Costa, J.de A, Alfenas, R.de C.G
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-03-2017
Subjects:
Acute-Phase Proteins
Carrier Proteins - blood
Diabetes mellitus
Diabetes Mellitus - blood
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 2 - blood
Endocrinology & Metabolism
Endotoxemia - blood
Endotoxin
Humans
Insulin Resistance
Lipopolysaccharide
Lipopolysaccharide-binding protein
Lipopolysaccharides - blood
Membrane Glycoproteins - blood
Lipopolysaccharide-binding protein
Lipopolysaccharide
Diabetes Mellitus
Endotoxin
Insulin Resistance
Insulin resistance
Diabetes mellitus
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Summary:Abstract In this systematic review we analyzed studies that assessed serum concentrations of lipopolysaccharide (LPS) and/or lipopolysacharide-binding protein (LBP) in diabetic patients compared with healthy people. Articles were selected using PubMed and Scopus. Search terms used were endotoxemia, endotoxins, LPS, LBP, diabetes mellitus (DM), type 1 (T1DM), type 2 (T2DM), insulin resistance, humans, epidemiologic studies, population-based, survey, representative, cross-sectional, case–control studies, observational, and clinical trials. Two authors independently extracted articles using predefined data fields, including study quality indicators. There was a great variability in the estimates of metabolic endotoxemia among the studies. Most of the studies observed higher LPS or LBP concentrations in diabetic subjects than in healthy controls. T1DM and T2DM subjects presented higher mean fasting LPS of 235.7% and 66.4% compared with non-diabetic subjects, respectively. Advanced complications (e.g. macroalbuminuria) and disease onset exacerbate endotoxemia. Antidiabetic medications decrease fasting LPS concentrations. Among these medications, rosiglitazone and insulin present lower and higher effects, respectively, compared with other treatments. T1DM and T2DM seem to increase metabolic endotoxemia. However, some confounders such as diet, age, medication, smoking and obesity influence both diabetes and endotoxemia manifestation. A better understanding of the interaction of these factors is still needed.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-Review-4
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ISSN:0026-0495
1532-8600
DOI:10.1016/j.metabol.2016.12.009