Endocrine Abstracts

Background: Inflammation is involved in the pathogenesis of complications of type 1 diabetes (T1DM). We aimed to assess the differences in the markers of endotoxaemia and faecal calprotectin in patients with T1D different status of diabetic kidney disease (DKD).

Methods: 31 generally healthy adults (control) and 74 patients with T1DM and were included. Of the latter, 13 had DKD (defined as microalbuminuria, macroalbuminuria, estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73², end stage kidney disease). In serum, lipopolysaccharide (LPS) activity was measured by Limulus Amebocyte Lysate assay, lipopolysaccharide binding protein (LPB), endogenous anti-endotoxin core antibodies (EndoCAb IgG and IgM), high sensitivity C reactive protein (hsCRP) and faecal calprotectin were measured by ELISA.

Results: The mean age in the T1D group was 42.3±15.2 years and in the healthy participant group 37.3±10.6 years. In the T1D group, the mean diabetes duration was 23.1±12.2 years, the mean HbA1c was 8.2±1.9%. Patients with and without DKD did not differ in age, anthropometric measures, prevalence of cardiovascular hard endpoints. Patients with DKD had longer T1D duration (P=0.04); higher prevalence of arterial hypertension (P=0.08); severe retinopathy (P=0.010); end-stage renal disease (P=0.029), and previous gastrointestinal surgery (P=0.02). The levels of EndoCAb IgG and IgM did not differ between T1D and control. Compared to control group, patients with T1D had statistically significantly lower LPS (LPS: T1D 0.23 ng/ml (0.22;0.31) control 0.38 ng/ml (0.32;0.56), P=0.009) and hsCRP (T1D 894.57 ng/ml (1255.91; 1990.92), control 313.29 ng/ml (368.82; 1173.07), P=0.01). LPB was higher in T1D, compared to control, but the difference did not reach statistical significance (T1D: 11444.50 ng/ml (11076.45;13058.45), control 9776.60 ng/ml (8991.34; 12911.32)). None of the markers differed between DKD groups. The level of calprotectin did not differ neither between controls and T1D, nor between T1D patients with and without DKD. Within patients with T1D and DKD, LPS correlated positively strongly with serum creatinine and albuminuria; LPB correlated with HbA1c. In the whole cohort, LPS correlated weakly positively with faecal calprotectin.

Conclsions: In patients with T1D and DKD, markers of serum inflammation are associated with kidney function and HbA1c.

Acknowledgements: Postdoctoral project Nr. 1.1.1.2/VIAA/3/19/525 ‘Intestinal inflammation as a potentially modifiable risk factor for complications in type 1 diabetes’ and a grant in Biomedicine and Pharmacy ‘Research of biomarkers and natural substances for acute and chronic diseases’ diagnostics and personalized treatment’ by the University of Latvia. MikroTik donation administered by Foundation of the University of Latvia.