Increased intestinal permeability to oral chromium (51Cr) -EDTA in human Type 2 diabetes

• Published in: Diabetic medicine Vol. 31; no. 5; pp. 559 - 563
• Main Authors: Horton, F., Wright, J., Smith, L., Hinton, P. J., Robertson, M. D.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.05.2014; Blackwell; Wiley Subscription Services, Inc
• Subjects: Administration, Oral; Biological and medical sciences; Biomarkers - metabolism; C-Reactive Protein - metabolism; Case-Control Studies; Cell Membrane Permeability - physiology; Chromium Radioisotopes - administration & dosage; Chromium Radioisotopes - urine; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - urine; Diabetes. Impaired glucose tolerance; Edetic Acid - administration & dosage; Edetic Acid - urine; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Humans; Interleukin-6 - blood; Intestinal Absorption - physiology; Intestinal Mucosa - metabolism; Intestines - cytology; Male; Medical sciences; Middle Aged; Tumor Necrosis Factor-alpha - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Endocrinopathy; Type 2 diabetes; Human; Obesity; Nutrition; Digestive system; Nutrition disorder; Gut; Oral administration; Metabolic diseases; Permeability; EDTA; Chromium; Endocrinology; Nutritional status
• DOI: 10.1111/dme.12360
• ISSN: 0742-3071; 1464-5491

Objective In animal models of obesity and Type 2 diabetes, permeability of the intestine is increased because of impairment of tight junction proteins, allowing translocation of bacterial endotoxin and resulting in low‐grade systemic inflammation. This has yet to be demonstrated in humans. The objective of this study was the demonstration of increased intestinal permeability in human Type 2 diabetes. Methods We examined intestinal permeability using chromium (51Cr)‐EDTA urinary recovery in twenty well‐controlled men with Type 2 diabetes compared with control subjects matched for age, gender and BMI. Results Intestinal permeability was significantly increased (P = 0.002) in the diabetic group and was correlated to increased levels of systemic inflammatory markers high‐sensitivity C‐reactive protein (r = 0.694, P = 0.001), interleukin 6 (r = 0.548, P = 0.012) and tumour necrosis factor alpha (r = 0.564, P = 0.010). Conclusion This is the first demonstration that increased intestinal permeability may be a feature of human Type 2 diabetes. What's new? There is increasing evidence linking an inflammatory cascade originating in the gut with systemic inflammation and the development of metabolic disease. An early and key feature of this cascade is an increase in intestinal permeability, although this has yet to be demonstrated in human diabetes. In this proof of concept study, we demonstrate for the first time an increase in intestinal permeability in people with Type 2 diabetes.