Gut permeability is related to body weight, fatty liver disease, and insulin resistance in obese individuals undergoing weight reduction
| Autor: | Valentina Volynets, Sandrine Louis, Anna Schnitzer, Andreas Rings, M Basrai, Antje Damms-Machado, Stephan C. Bischoff |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Cholera Toxin medicine.medical_specialty Medicine (miscellaneous) Models Biological Permeability Body Mass Index Young Adult 03 medical and health sciences 0302 clinical medicine Insulin resistance Weight loss Internal medicine Weight Loss medicine Humans Mannitol Obesity Protein Precursors Nutrition and Dietetics Intestinal permeability Haptoglobins Interleukin-6 business.industry Body Weight Fatty liver Zonulin Middle Aged medicine.disease Lactulose Fatty Liver Intestines 030104 developmental biology Endocrinology Intestinal Absorption Homeostatic model assessment Female 030211 gastroenterology & hepatology Insulin Resistance Waist Circumference Steatosis medicine.symptom business Body mass index Follow-Up Studies |
| Zdroj: | The American Journal of Clinical Nutrition. 105:127-135 |
| ISSN: | 0002-9165 |
| Popis: | BACKGROUND Obesity and associated metabolic disorders are related to impairments of the intestinal barrier. OBJECTIVE We examined lactulose:mannitol (Lac:Man) permeability in obese individuals with and without liver steatosis undergoing a weight-reduction program to test whether an effective weight-loss program improves gut barrier function and whether obese patients with or without liver steatosis differ in this function. DESIGN Twenty-seven adult, nondiabetic individuals [mean ± SD body mass index (BMI; in kg/m2): 43.7 ± 5.2; 78% with moderate or severe liver steatosis] were included in the follow-up intervention study (n = 13 by month 12). All patients reduced their weight to a mean ± SD BMI of 36.4 ± 5.1 within 12 mo. We assessed barrier functions by the oral Lac:Man and the fecal zonulin tests. Insulin resistance was assessed by the homeostatic model assessment index (HOMA), and liver steatosis by sonography and the fatty liver index (FLI). RESULTS The Lac:Man ratio and circulating interleukin (IL) 6 concentration decreased during intervention from 0.080 (95% CI: 0.073, 0.093) to 0.027 (95% CI: 0.024, 0.034; P < 0.001) and from 4.2 ± 1.4 to 2.8 ± 1.6 pg/mL (P < 0.01), respectively. At study start, the Lac:Man ratio was higher in patients with moderate or severe steatosis than in those without any steatosis (P < 0.001). The Lac:Man ratio tended to correlate with HOMA (ρ = 0.55, P = 0.052), which correlated with FLI (ρ = 0.75, P < 0.01). A multiple-regression analysis led to a final model explaining FLI best through BMI, waist circumference, and the Lac:Man ratio. CONCLUSIONS Intestinal permeability is increased in obese patients with steatosis compared with obese patients without. The increased permeability fell to within the previously reported normal range after weight reduction. The data suggest that a leaky gut barrier is linked with liver steatosis and could be a new target for future steatosis therapies. This trial was registered at clinicaltrials.gov as NCT01344525. |
| Databáze: | OpenAIRE |
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