Imbalance of endotoxin-binding systems in patients with type 1 diabetes

Rationale. The number of patients with type 1 diabetes mellitus (DM1) in the Russian Federation is 277.1 thousand people, and this number continues to grow. Disturbance of glycemia leads to the development of oxidative stress and damage to the walls of the vascular channel, increasing cardiovascular risk in patients with DM1. Endothelial and enterocyte damage leads to translocation of bacterial components, particularly lipopolysaccharide (LPS), into the systemic bloodstream and the development of a state of “metabolic endotoxemia” that supports inflammation. The aim of the study. To evaluate the levels of all major LPS-binding systems and C-reactive protein (CRP) levels in patients with DM1. Materials and methods. The study included 92 patients with a verified diagnosis of type 1 diabetes mellitus. A control group of 42 practically healthy respondents, who were comparable to the DM1 group in terms of age and gender, was also formed. Patients in both groups were examined for biomaterial (blood plasma) by enzyme-linked immunosorbent assay (ELISA) to determine the level of lipopolysaccharide-binding protein (LBP), bactericidal permeability-increasing protein (BPI) and sCD14, as well as a marker of systemic inflammation – CRP. Results. In patients with DM1, there was a statistically significant increase in the levels of LBP and sCD14 compared to the corresponding indicators of the control group (p < 0.001). BPI levels were significantly lower in the group of patients with DM1 than in the control group (p < 0.001). The DM1 group had a statistically higher CRP level of 0.81 (0.43–2.07) compared to the control group (p < 0.001). Conclusion. Our results indicate the dysregulation and imbalance of LPS-binding systems in patients with DM1. We also found a significantly higher level of SRB in patients with DM1, which confirms the presence of low-intensity inflammation in these patients.