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02-02-2011 | Infectious disease | Article

High endotoxin activity levels increase risk for Type 2 diabetes


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MedWire News: High levels of endotoxin activity are independently associated with an increased risk for Type 2 diabetes, report researchers who say these results may indicate a link between metabolic disorders and chronic low-grade inflammation.

It has been suggested that endotoxins, which are largely derived from Gram-negative bacteria, can act as inflammatory triggers for conditions like the metabolic syndrome and diabetes.

Pirkko Pussinen (University of Helsinki, Finland) and colleagues therefore investigated whether patients with prevalent (present at baseline; n=537) or incident (diagnosed during follow-up; n=462) Type 2 diabetes from the FINRISK97 cohort had higher levels of endotoxin activity than people without diabetes.

In total, 7169 individuals aged 25-74 years were followed-up for a period of 10 years. Endotoxin level was measured at baseline using a limulus assay.

Endotoxin levels were significantly higher in patients with prevalent or incident diabetes than in individuals without the condition, at a mean of 70.73 and 77.03 versus 61.06 EU/ml, respectively.

The researchers found that each unit increase in endotoxin activity resulted in a 0.4% increase in risk for incident Type 2 diabetes. This translated to a 52% increase in risk for incident diabetes among those in the top quartile for endotoxin activity compared with those in the bottom quartile.

This association was independent of diabetes risk factors such as serum lipid levels, C-reactive protein level, body mass index, and blood glucose level. The association between endotoxemia and incident diabetes was also independent of the metabolic syndrome, as defined by either the National Cholesterol Educational Program-Adult Treatment Panel III or the International Diabetes Federation.

Pussinen and team observed a positive correlation between endotoxin activity levels and the presence of increasing numbers of components of the metabolic syndrome.

"Our results indicate for the first time that endotoxemia is a key player in the pathogenesis of diabetes and that microbes may have a central role," conclude the authors.

The results of this study are published in the journal Diabetes Care.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Helen Albert

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