Small intestinal alterations in severely obese hyperglycemic subjects.
J Clin Endocrinol Metab
; 96(2): E379-83, 2011 Feb.
Article
em En
| MEDLINE
| ID: mdl-21084402
ABSTRACT
CONTEXT Type 2 diabetes mellitus (DM2) is associated with small intestinal hyperplasia and hypertrophy in rodents. Moreover, the small intestine is increasingly acknowledged to play a role in the pathophysiology of DM2. OBJECTIVE:
The objective of the study was to investigate the relation between plasma markers of small intestinal function and chronic hyperglycemia in man. DESIGN, SETTING, ANDPARTICIPANTS:
We conducted a cross-sectional observational study of 40 severely obese subjects with chronic hyperglycemia and 30 severely obese subjects without chronic hyperglycemia who were indicated for bariatric surgery. MAIN OUTCOMEMEASURES:
We assessed plasma levels of citrulline, representing small intestinal enterocyte mass, intestinal fatty acid binding protein (I-FABP), a marker of enterocyte loss, and glucagon-like peptide-2, an intestinotrophic factor, and related them to glycated hemoglobin (HbA(1c)) levels.RESULTS:
Plasma citrulline and I-FABP levels were both significantly elevated in subjects with chronic hyperglycemia (HbA(1c) > 6.0%) compared with subjects with a normal HbA(1c) (≤ 6.0%) (citrulline, 35 ± 2.1 µm vs. 26 ± 1.4 µm, P = 0.001; I-FABP, 140 ± 22 pg/ml vs. 69 ± 14 pg/ml, P = 0.001). Moreover, plasma citrulline and I-FABP levels correlated with HbA(1c) levels (citrulline, r(s) = 0.30, P = 0.02; I-FABP, r(s) = 0.33, P = 0.005). The I-FABP to citrulline ratio was higher in subjects with an elevated HbA(1c) (4.0 vs. 3.1, P = 0.03). Plasma glucagon-like peptide-2 levels were not related to citrulline or I-FABP levels (r(s) = 0.06, P = 0.67; r(s) 0.08, P = 0.54, respectively).CONCLUSION:
Chronically elevated glucose levels in obese individuals are associated with increased small intestinal enterocyte mass and increased enterocyte loss. These findings argue for the further exploration of the role of the intestine in the pathophysiology of DM2.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hiperglicemia
/
Intestino Delgado
/
Obesidade
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Holanda