KROONINEN TULEHDUS/DIABETES

[Bb]

Lähettäjä: Soijuv Lähetetty: 29.5.2006 12:41

Useille taudinaiheuttajille altistuminen aiheuttaa lievän kroonisen tulehdustilan josta voi seurata insuliiniresistenssi ja 2-tyypin diabetes.


Diabetes Care. 2006 May;29(5):1058-64.

Burden of infection and insulin resistance in healthy middle-aged men.

Fernandez-Real JM, Lopez-Bermejo A, Vendrell J, Ferri MJ, Recasens M,
Ricart W.

Section of Diabetes, Endocrinology and Nutrition, Institut
d'Investigacio Biomedica de Girona, Avinguda de Franca s/n, 17007
Girona, Spain. uden.jmfernandezreal@...

OBJECTIVE: We hypothesized that burden of infection could be
associated with chronic low-grade inflammation, resulting in insulin
resistance. We aimed to study the effect of exposure to four
infections on insulin sensitivity in apparently healthy middle-aged
men (n = 124). RESEARCH DESIGN AND METHODS: By inclusion criteria,
all subjects were hepatitis C virus antibody seronegative. Each study
subject's serum was tested for specific IgG class antibodies against
herpes simplex virus (HSV)-1, HSV-2, enteroviruses, and Chlamydia
pneumoniae through the use of quantitative in vitro enzyme-linked
immunosorbent assays. Insulin sensitivity was evaluated using minimal
model analysis. RESULTS: The HSV-2 titer was negatively associated
with insulin sensitivity even after controlling for BMI, age, and C-
reactive protein (CRP). The associations were stronger when
considering the infection burden.

In particular, in those subjects
who were seropositive for C. pneumoniae, the relationship between the
quantitative seropositivity index (a measure of the exposure to
various pathogens) and insulin sensitivity was strengthened (r = -
0.50, P < 0.0001).

We also observed decreasing mean insulin sensitivity index with
increasing seropositivity score in subjects positive for
enteroviruses. In the latter, the relationship between insulin
sensitivity and seropositivity was especially significant (r = -0.71,
P < 0.0001). In a multivariate regression analysis, both BMI and
quantitative seropositivity index (7%) independently predicted
insulin sensitivity variance in subjects with C. pneumoniae
seropositivity. When controlling for CRP, this association was no
longer significant.

CONCLUSIONS: Pathogen burden showed the strongest association with
insulin resistance, especially with enteroviruses and C. pneumoniae
seropositivity. We hypothesize that exposure to multiple pathogens
could cause a chronic low-grade inflammation, resulting in insulin
resistance.