Endocrine Abstracts

Association of type 2 diabetes, NAFLD, intestinal dysbiosis and endotoxemia is a trigger factor of cytokine cascade which manifest in proinflammatory state development, insulin resistance, hyperglycemia and dyslipidemia progression. The aim of this study is to reveal the effect of multiprobiotic Symbiter (symbiotic association of 14–24 strains of Bifidobacterium Lactobacillus, Propionibacterium, Lactococcus lactis, Streptococcus, Acetobacter aceti) and hepatoprotector Glutargin (arginine and glutamic acid salt) on proinflammatory cytokine levels and endotoxemia in patients with type 2 diabetes and NAFLD. Materials and methods. We observed 64 patients with type 2 diabetes and NAFLD who received oral hypoglycaemic agents, hepatoprotector Glutargin (0.75 g three times a day) together with multiprobiotic Symbiter (10 g twice daily) during 30 days. The control group consisted of 25 apparently healthy individuals. The concentration of the cytokines (IL 6, 8, TNF-α) in both blood serum and coprofiltrates and levels of antibodies to LPS in blood serum were determined by enzyme-linked immunosorbent assay (ELISA). The state of intestine microbiota was evaluated based on the results of bacteriological examination of faeces. Results and discussion. Before treatment patients with type 2 diabetes and NAFLD had significant increased blood proinflammatory cytokines concentrations indicating severe inflammatory and immunopathological reactions. We also revealed increased levels of IgG antibodies to LPS and proinflammatory cytokines in coprofiltrates which had strong correlation with dysbiotic disorders rate, reflecting the inductive role of Gram-negative flora endotoxin in inflammation progression in these patients. Conclusions. The use of Glutargin and multiprobiotic Symbiter complex reduced systemic inflammation by statistically significant decrease of serum proinflammatory cytokines and endotoxemia levels in patients with type 2 diabetes with NAFLD, which directly correlated with intestinal microbiota improvement. Due to this we consider that dysbiosis correction improve immunological status in this patients.