title: Endotoxemia, nutrition, and cardiometabolic disorders.
abstract: OBJECTIVE
  Circulating lipopolysaccharides (LPSs), associated with both infection and inflammation, may arise from the gastrointestinal tract microbiota, and the levels may be affected by daily nutrition. We investigated whether nutrient intake affects the association of serum LPS activity with prevalent obesity, metabolic syndrome (MetS), diabetes, and coronary heart disease (CHD) and with the risk of incident CHD events.
  
  
  METHODS
  The nutrition cohort (n = 2,452, mean age ± SD, 52.2 ± 10.1 years) of the FINRISK 1997 Study was followed up for 10 years. Information on macronutrient intake at baseline was collected from 24-h dietary recall. Serum endotoxin activities were determined by the Limulus amebocyte lysate assay.
  
  
  RESULTS
  LPS activity was associated directly with the total energy intake and indirectly with carbohydrate intake in lean, healthy subjects. High LPS was significantly associated with prevalent obesity, MetS, diabetes, and CHD events, independently of established risk factors, CRP, and total energy or nutrient intake. The ORs (95 % CI) were 1.49 (1.21-1.85, p < 0.001, Q2-4 vs. Q1) for obesity, 2.56 (1.97-3.32, p < 0.001, Q2-4 vs. Q1) for MetS, 1.94 (1.06-3.52, p = 0.031, Q2-4 vs. Q1) for CHD, and 1.01 (1.00-1.01, p = 0.032, LPS unit) for diabetes. In the follow-up, high LPS was significantly associated with the risk of CHD events with a hazard ratio of 1.88 (1.13-3.12, p = 0.013, Q2-4 vs. Q1). This association was independent of baseline established risk factors, diet, obesity, MetS, and diabetes.
  
  
  CONCLUSIONS
  A high serum LPS activity is strongly associated with cardiometabolic disorders, which supports the role of bacterial infections and immune response in their etiology.
authors.affiliation: Institute of Dentistry, University of Helsinki, Biomedicum 1, P.O. Box 63, 00014, Helsinki, Finland, elisa.kallio@helsinki.fi.
authors.forename: K A Elisa
authors.initials: KA
authors.lastname: Kallio
authors.forename: Katja A
authors.initials: KA
authors.lastname: Hätönen
authors.forename: Markku
authors.initials: M
authors.lastname: Lehto
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Satu
authors.initials: S
authors.lastname: Männistö
authors.forename: Pirkko J
authors.initials: PJ
authors.lastname: Pussinen
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood*; D019446:Endotoxemia / Q000097:blood*; D004731:Endotoxins / Q000097:blood; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment
chemical_list: D004731:Endotoxins; D008070:Lipopolysaccharides