Bacterial DNA Translocation Holds Increased Insulin Resistance and Systemic Inflammatory Levels in Morbid Obese Patients

Abstract

Bacterial DNA translocation holds increased insulin resistance and systemic inflammatory levels in morbidly obese patients despite significant weight loss.

Metabolic endotoxemia with obesity: Is it real and is it relevant?

“…It is also near impossible to determine an endotoxin concentration at which cardio-metabolic and pro-inflammatory symptoms ensue during metabolic endotoxemia. Conversely, what is consistent in the human studies reviewed herein is that the endotoxin concentration changes between lean and obese individuals, and decreases in circulating endotoxin concentration following weight loss and/or gut modulation therapy 27, 83, 84, 86, 87, 89, 105 , have been between 0.5–2 fold 25, 26, 50, 6127, 83, 84, 86, 87, 89, 105 . Furthermore, the 0.5–2.0-fold change in endotoxin has been accompanied by concomitant changes in metabolism, with or without changes in immune system activation in these studies.…”

“…Therefore, reducing caloric intake and/or modulating the gut microbiota (e.g., pre-, pro-, or synbiotics) may reduce circulating endotoxin and metabolic perturbations. Some studies show that bariatric surgery leads to altered gut microbiota 82 , reductions in circulating endotoxin 27, 83 , reductions in pro-inflammatory pathways 27, 82, 83 , and improvements in glucose homeostasis 27, 82, 83 . Monte et al 27 showed that, in addition to reductions in circulating endotoxin, TLR4, TLR2, and CD14 mRNA expression, and NFκB binding to DNA in mononuclear cells were all significantly reduced following Roux-en-Y gastric bypass surgery (RYGB) surgery.…”

“…Monte et al 27 showed that, in addition to reductions in circulating endotoxin, TLR4, TLR2, and CD14 mRNA expression, and NFκB binding to DNA in mononuclear cells were all significantly reduced following Roux-en-Y gastric bypass surgery (RYGB) surgery. Furthermore, by measuring bacterial DNA (broad range PCR and of prokaryote 16sRNA) in plasma, Ortiz et al 83 only showed reductions in pro-inflammatory pathways and insulin resistance following surgical (RYGB and sleeve gastrectomy) weight loss in subjects who had concomitant reductions in circulating bacterial DNA. However, these results should be interpreted with caution since only a small number of subjects had increases or no change in circulating bacterial DNA content following weight loss.…”

“…To complicate matters more, others have reported endotoxin concentrations of septic individuals below 1 EU/mL 104 . Furthermore, some groups report endotoxin concentrations in pg/mL, with absolute values of endotoxin differing greatly between studies 25, 60, 83 . Therefore, distinguishing an absolute range of metabolic endotoxemia using the description of metabolic endotoxemia as a condition of chronically elevated plasma LPS at levels 10–50 times lower than during septic conditions is near impossible when comparing between endotoxin concentrations of healthy, obese/T2D, and septic individuals across studies.…”

Factors of microinflammation in non-diabetic chronic kidney disease: a pilot study

“…CKD is associated with increased levels of oxidative stress markers such as oxidized nucleic acid, protein and lipid at different stages [14,15]. Metabolic conditions such as insulin resistance and obesity, that are frequently present in CKD patients can even more enhance oxidative stress [12] and bacterial translocation [16,17] and thus participate in microinflammation.…”