title: Bacterial endotoxin activity in human serum is associated with dyslipidemia, insulin resistance, obesity, and chronic inflammation.
abstract: OBJECTIVE
  To investigate whether bacterial lipopolysaccharide (LPS) activity in human serum is associated with the components of the metabolic syndrome (MetS) in type 1 diabetic patients with various degrees of kidney disease and patients with IgA glomerulonephritis (IgAGN).
  
  
  METHODS
  Serum LPS activity was determined with the Limulus Amoebocyte Lysate chromogenic end point assay in type 1 diabetic patients with a normal albumin excretion rate (n = 587), microalbuminuria (n = 144), macroalbuminuria (n = 173); patients with IgAGN (n = 98); and in nondiabetic control subjects (n = 345). The relationships of the LPS/HDL ratio and MetS-associated variables were evaluated with Pearson correlation.
  
  
  RESULTS
  The MetS was more prevalent in type 1 diabetic patients (48%) than in patients with IgAGN (15%). Diabetic patients with macroalbuminuria had a significantly higher serum LPS/HDL ratio than patients with IgAGN. In the normoalbuminuric type 1 diabetic group, patients in the highest LPS/HDL quartile were diagnosed as having the MetS three times more frequently than patients in the lowest quartile (69 vs. 22%; P < 0.001). High LPS activity was associated with higher serum triglyceride concentration, earlier onset of diabetes, increased diastolic blood pressure, and elevated urinary excretion of monocyte chemoattractant protein-1.
  
  
  CONCLUSIONS
  High serum LPS activity is strongly associated with the components of the MetS. Diabetic patients with kidney disease seem to be more susceptible to metabolic endotoxemia than patients with IgAGN. Bacterial endotoxins may thus play an important role in the development of the metabolic and vascular abnormalities commonly seen in obesity and diabetes-related diseases.
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland.
authors.forename: Mariann I
authors.initials: MI
authors.lastname: Lassenius
authors.forename: Kirsi H
authors.initials: KH
authors.lastname: Pietiläinen
authors.forename: Kati
authors.initials: K
authors.lastname: Kaartinen
authors.forename: Pirkko J
authors.initials: PJ
authors.lastname: Pussinen
authors.forename: Jaana
authors.initials: J
authors.lastname: Syrjänen
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Ilkka
authors.initials: I
authors.lastname: Pörsti
authors.forename: Aila
authors.initials: A
authors.lastname: Rissanen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
authors.forename: Jukka
authors.initials: J
authors.lastname: Mustonen
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
authors.forename: Markku
authors.initials: M
authors.lastname: Lehto
mesh_terms: D000419:Albuminuria / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D050171:Dyslipidemias / Q000097:blood*; D005922:Glomerulonephritis, IGA / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D007674:Kidney Diseases / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood*; D024821:Metabolic Syndrome / Q000097:blood; D009765:Obesity / Q000097:blood*; D014280:Triglycerides / Q000097:blood
chemical_list: D008070:Lipopolysaccharides; D014280:Triglycerides