Institute of Dentistry, University of Helsinki, Helsinki, Finland.
Diabetes Care. 2011 Feb;34(2):392-7. doi: 10.2337/dc10-1676.
Diabetes is accompanied with a chronic low-grade inflammation, which may in part be mediated by endotoxins derived from Gram-negative bacteria.
We investigated in a population-based cohort whether endotoxemia is associated with clinically incident diabetes. The serum endotoxin activity was measured by limulus assay from the FINRISK97 cohort comprising 7,169 subjects aged 25-74 years and followed up for 10 years.
Both the subjects with prevalent diabetes (n = 537) and those with incident diabetes (n = 462) had higher endotoxin activity than the nondiabetic individuals (P < 0.001). The endotoxin activity was significantly associated with increased risk for incident diabetes with a hazard ratio 1.004 (95% CI 1.001-1.007; P = 0.019) per unit increase resulting in a 52% increased risk (P = 0.013) in the highest quartile compared with the lowest one. The association was independent of diabetes risk factors: serum lipids, γ-glutamyl transferase, C-reactive protein, BMI, and blood glucose. Furthermore, the association of endotoxemia with an increased risk of incident diabetes was independent of the metabolic syndrome as defined either by the National Cholesterol Educational Program-Adult Treatment Panel III or the International Diabetes Federation. Endotoxin activity was linearly related (P < 0.001) to the number of components of the metabolic syndrome.
Both prevalent and incident diabetes were associated with endotoxemia, which may link metabolic disorders to inflammation. The results suggest that microbes play a role in the pathogenesis of diabetes.
糖尿病伴有慢性低度炎症，这种炎症部分可能是由革兰氏阴性菌衍生的内毒素所介导的。
我们在一项基于人群的队列研究中调查了内毒素血症是否与临床新诊断的糖尿病有关。血清内毒素活性通过鲎试验（limulus assay）从 FINRISK97 队列中进行测量，该队列包含 7169 名年龄在 25-74 岁之间的个体，随访 10 年。
既有现患糖尿病（n=537）又有新发糖尿病（n=462）的患者的内毒素活性均高于非糖尿病个体（P<0.001）。内毒素活性与新发糖尿病风险显著相关，风险比为 1.004（95%CI 1.001-1.007；P=0.019），每增加一个单位，风险增加 52%（P=0.013），最高四分位数与最低四分位数相比。这种关联独立于糖尿病的危险因素：血清脂质、γ-谷氨酰转移酶、C 反应蛋白、BMI 和血糖。此外，内毒素血症与新发糖尿病风险增加的关联独立于代谢综合征，无论是根据国家胆固醇教育计划-成人治疗专家组 III 还是国际糖尿病联合会来定义代谢综合征。内毒素活性与代谢综合征的组成成分数量呈线性相关（P<0.001）。
现患和新发糖尿病均与内毒素血症有关，这可能将代谢紊乱与炎症联系起来。这些结果表明，微生物在糖尿病的发病机制中起作用。
