title: Evidence for metabolic endotoxemia in obese and diabetic Gambian women.
abstract: OBJECTIVE
  Emerging evidence from animal models suggests that translocation of bacterial debris across a leaky gut may trigger low-grade inflammation, which in turn drives insulin resistance. The current study set out to investigate this phenomenon, termed 'metabolic endotoxemia', in Gambian women.
  
  
  METHODS
  In a cross-sectional study, we recruited 93 age-matched middle-aged urban Gambian women into three groups: lean (body mass index (BMI): 18.5-22.9 kg m(-2)), obese non-diabetic (BMI: 30.0 kg m(-2)) and obese diabetic (BMI: 30.0 kg m(-2) and attending a diabetic clinic). We measured serum bacterial lipopolysaccharide (LPS) and endotoxin-core IgM and IgG antibodies (EndoCAb) as measures of endotoxin exposure and interleukin-6 (IL-6) as a marker of inflammation.
  
  
  RESULTS
  Inflammation (IL-6) was independently and positively associated with both obesity and diabetes (F=12.7, P<0.001). LPS levels were highest in the obese-diabetic group compared with the other two groups (F=4.4, P<0.02). IgM EndoCAb (but not total IgM) was highly significantly reduced in the obese (55% of lean value) and obese diabetic women (30% of lean; F=21.7, P<0.0001 for trend) compared with lean women.
  
  
  CONCLUSIONS
  These data support the hypothesis that gut-derived inflammatory products are associated with obesity and diabetes. Confirmation of these findings and elucidation of the role of the microbiota, gut damage and the pathways for translocation of bacterial debris, could open new avenues for prevention and treatment of type 2 diabetes.
authors: Medical Research Council International Nutrition Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors: S
authors: S
authors: Hawkesworth
authors: S E
authors: SE
authors: Moore
authors: A J C
authors: AJ
authors: Fulford
authors: G R
authors: GR
authors: Barclay
authors: A A
authors: AA
authors: Darboe
authors: H
authors: H
authors: Mark
authors: O A
authors: OA
authors: Nyan
authors: A M
authors: AM
authors: Prentice
references: Nature. 2006 Dec 21;444(7122):1027-31
references: 17183312
references: Proc Natl Acad Sci U S A. 2007 Jan 16;104(3):979-84
references: 17210919
references: J Clin Invest. 2003 Dec;112(12):1821-30
references: 14679177
references: Proc Natl Acad Sci U S A. 2009 Feb 17;106(7):2365-70
references: 19164560
references: Int J Obes (Lond). 2011 Sep;35 Suppl 3:S45-9
references: 21912388
references: Diabetes Care. 2010 May;33(5):991-7
references: 20067961
references: Diabetes. 2007 Jul;56(7):1761-72
references: 17456850
references: Curr Pharm Des. 2009;15(13):1546-58
references: 19442172
references: Annu Rev Med. 2010;61:393-411
references: 20059345
references: Circ Shock. 1989 Oct;29(2):93-106
references: 2582583
references: Cardiovasc Diabetol. 2009 Apr 15;8:20
references: 19368716
references: Obes Res. 2001 Jul;9(7):414-7
references: 11445664
references: Curr Opin Immunol. 1999 Feb;11(1):19-22
references: 10047547
references: Aliment Pharmacol Ther. 2002 Apr;16(4):675-81
references: 11929384
references: J Nutr Biochem. 2010 Jun;21(6):550-5
references: 19361974
references: Biochimie. 2011 Jan;93(1):39-45
references: 20433893
references: BMC Gastroenterol. 2010 Jul 06;10:72
references: 20604937
references: Trends Immunol. 2004 Jan;25(1):4-7
references: 14698276
references: Diabetes Metab Res Rev. 2009 Sep;25 Suppl 1:S18-23
references: 19662619
references: Diabetes. 2008 Jun;57(6):1470-81
references: 18305141
references: J Immunol Methods. 1995 Oct 12;186(1):1-15
references: 7561138
references: Science. 1996 Feb 2;271(5249):665-8
references: 8571133
references: Proc Nutr Soc. 2000 Feb;59(1):147-54
references: 10828184
references: Am J Clin Nutr. 2004 Dec;80(6):1487-91
references: 15585759
references: Annu Rev Nutr. 2011 Aug 21;31:15-31
references: 21568707
references: J Clin Immunol. 1982 Apr;2(2 Suppl):7S-14S
references: 7045157
references: Nature. 2006 Dec 21;444(7122):1022-3
references: 17183309
references: Am J Clin Nutr. 2007 Nov;86(5):1286-92
references: 17991637
references: Am J Physiol Endocrinol Metab. 2007 Mar;292(3):E740-7
references: 17090751
references: Diabetes Care. 2009 Dec;32(12):2281-7
references: 19755625
references: Am J Physiol Endocrinol Metab. 2001 May;280(5):E745-51
references: 11287357
references: Science. 2005 Mar 25;307(5717):1915-20
references: 15790844
references: J Clin Invest. 2006 Jul;116(7):1793-801
references: 16823477
references: Diabetes Care. 2010 Oct;33(10):2277-84
references: 20876708
references: Intensive Care Med. 2006 Feb;32(2):286-294
references: 16450100
references: Gastroenterology. 2007 May;132(6):2169-80
references: 17498510
references: J Clin Endocrinol Metab. 2000 Jul;85(7):2402-10
references: 10902785
references: Am J Clin Nutr. 2008 May;87(5):1219-23
references: 18469242
references: Prog Clin Biol Res. 1995;392:263-72
references: 8524931