Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Biochemistry, All India Institute of Medical Sciences Rishikesh, Rishikesh, India.
Eur J Clin Invest. 2020 Jun;50(6):e13238. doi: 10.1111/eci.13238. Epub 2020 May 15.
Type 2 diabetes mellitus (T2DM) is most demanding public health problem of 21st century. Uncontrolled diabetes may cause complications affecting any part of gut from mouth to rectum presenting as vomiting, nausea, bloating, abdominal pain, constipation and diarrhoea. The aim of this study was to compare levels of oxidative stress and inflammatory markers in small intestinal bacterial overgrowth (SIBO)-positive and negative diabetic patients.
An observational analytical study was conducted on 300 T2DM (>5 years' duration) attending Diabetic Clinic. A total of 200 age- and sex-matched healthy individuals were enrolled as controls. Noninvasive glucose hydrogen breath test was used to diagnose SIBO. A total of 5 mL blood was taken. Plasma was used for measurement of inflammatory cytokines (TNF-α, IL-6 and IL-10) by ELISA. Hemolysate was used for measurement of lipid peroxidation, reduced GSH, superoxide dismutase and catalase.
It was observed that constipation was present in 59.6% T2DM patients. SIBO was observed significantly higher (P < .0001) in T2DM patients than controls. Inflammatory and oxidative stress markers were significantly (P < .001) higher in diabetic and SIBO-positive patients than controls and SIBO negative. Reduced GSH was significantly (P < .05) lower whereas superoxide dismutase (SOD) and catalase antioxidant enzymes were significantly (<.05) higher in diabetic and SIBO-positive patients than controls and SIBO-negative patients.
From this study, it could be concluded that SIBO in T2DM patients can cause oxidative stress and inflammation. Therefore, SIBO should be taken care to prevent further damage to intestine.
2 型糖尿病（T2DM）是 21 世纪最具挑战性的公共卫生问题。糖尿病未得到控制可能会导致从口腔到直肠的肠道各个部位发生并发症，表现为呕吐、恶心、腹胀、腹痛、便秘和腹泻。本研究旨在比较小肠细菌过度生长（SIBO）阳性和阴性的糖尿病患者的氧化应激和炎症标志物水平。
对 300 名（>5 年病程）在糖尿病诊所就诊的 T2DM 患者进行了一项观察性分析研究。共纳入 200 名年龄和性别匹配的健康个体作为对照。使用无创葡萄糖氢呼气试验诊断 SIBO。采集 5mL 血液。通过 ELISA 测定血浆中炎症细胞因子（TNF-α、IL-6 和 IL-10）。使用溶血物测定脂质过氧化、还原型谷胱甘肽、超氧化物歧化酶和过氧化氢酶。
研究发现，59.6%的 T2DM 患者存在便秘。T2DM 患者的 SIBO 发生率明显高于对照组（P<0.0001）。糖尿病和 SIBO 阳性患者的炎症和氧化应激标志物明显高于对照组和 SIBO 阴性患者（P<0.001）。与对照组和 SIBO 阴性患者相比，糖尿病和 SIBO 阳性患者的还原型谷胱甘肽（GSH）明显降低（P<0.05），而超氧化物歧化酶（SOD）和过氧化氢酶抗氧化酶明显升高（P<0.05）。
从这项研究可以得出结论，SIBO 可导致 T2DM 患者的氧化应激和炎症。因此，应注意 SIBO 以防止对肠道造成进一步损害。
