title: Increased intestinal permeability as a risk factor for type 2 diabetes.
abstract: OBJECTIVE
  Relationships between the intestinal microbiota, intestinal permeability and inflammation in the context of risk for obesity-associated disease continue to be of interest. The aim of the study was to examine the associations between intestinal permeability and type 2 diabetes (T2D).
  
  
  METHODS
  A total of 130 individuals with T2D (age: 57.5±6.2 years (mean±SD); BMI: 30.4±3.2; 45% female) and 161 individuals without T2D (age: 37.4±12.5 years; BMI: 25.1±3.9; 65% female) were included in the study. Assessment of intestinal permeability included measurement of circulating lipopolysaccharide (LPS), LPS-binding protein (LBP) and intestinal fatty acid binding protein (iFABP) concentrations, which were used for calculation of a derived permeability risk score (PRS). Associations between permeability measures and T2D status were assessed using logistic regression models.
  
  
  RESULTS
  LBP (∼34%, P<0.001), iFABP (∼46%, P<0.001) and the PRS (∼24% P<0.001) were all significantly higher in the T2D affected individuals. Individuals with a PRS in the upper tertile were 5.07 times more likely (CI: 1.72-14.95; P=0.003) to have T2D when models were adjusted for age, sex and BMI. There was a trend towards improved prediction when including the PRS in models containing age, sex and BMI (AUC: 0.954 versus 0.962; P=0.06).
  
  
  CONCLUSIONS
  These data demonstrate differences in measures of intestinal permeability between individuals with and without T2D. The utility of using intestinal permeability measures as a tool for predicting T2D risk in at risk individuals should be further investigated.
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Parklands Drive, 4215 Southport, QLD, Australia; School of Medical Science, Griffith University, Southport, QLD, Australia. Electronic address: a.cox@griffith.edu.au.
authors.forename: A J
authors.initials: AJ
authors.lastname: Cox
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Parklands Drive, 4215 Southport, QLD, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Centre for Diabetes Research and Department of Biochemistry, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Bowden
authors.affiliation: Digestive Diseases Queensland, Chermside, QLD, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Devereaux
authors.affiliation: Diabetes and Endocrinology, Gold Coast University Hospital, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: Davoren
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Parklands Drive, 4215 Southport, QLD, Australia.
authors.forename: A W
authors.initials: AW
authors.lastname: Cripps
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Parklands Drive, 4215 Southport, QLD, Australia; School of Medical Science, Griffith University, Southport, QLD, Australia.
authors.forename: N P
authors.initials: NP
authors.lastname: West
mesh_terms: D000209:Acute-Phase Proteins; D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002352:Carrier Proteins / Q000097:blood*; D003924:Diabetes Mellitus, Type 2; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D008070:Lipopolysaccharides / Q000097:blood*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D010539:Permeability; D012307:Risk Factors; D055815:Young Adult; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins; D008070:Lipopolysaccharides; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein
keywords: Diabetes; Inflammation; Intestinal permeability; Prediction