Abstract
Objectives: In the last decade gut microbial diversity was associated with the pathogenesis of obesity in humans. Plasma citrulline was a simple and accurate biomarker for the severity of intestinal failure and was associated with short bowel syndrome and alteration of gut permeability, being developed as an alternative to D-xylose tolerance test for the diagnosis of an abnormal small intestinal absorption of nutrients. This study was performed to ascertain whether obesity might be associated with dysregulation of epithelial gut function. Methods: Fifteen obese individuals (5 M/10 F; BMI 37.4 ± 6.1 Kg/m2; 42 ± 6 yrs) and 15 healthy gender- and age-matched controls (6 M/9 F BMI: 22.7 ± 2.1 Kg/m2; 39 ± 7 yrs) underwent D-xylose load (25 g) and plasma citrulline, plasma insulin, glucose and lipid profile testing. Results: Plasma citrulline was significantly lower in the obese group (p = 0.045) with respect to controls, whilst total cholesterol, LDL and trygliceri- des concentration, insulin level and HOMA-IR were significantly higher in obese patients. In contrast, after D-xylose load no difference in serum xylose was found between the two groups (p = ns). Conclusions: Obese patients show a decreased citrulline concentration with respect to lean subjects. Since citrulline is a known marker of intestinal health, alterations in the gut epithelium are likely to be associated with the obesity syndrome. We propose to measure citrulline level in obese patients on a routine basis.
Highlights
Overweight and obesity are major risk factors for a number of chronic-degenerative diseases
Plasma citrulline concentration was lower in obese patients with respect to controls (p = 0.045), indicating a reduction of production of this amino-acid by small bowel epithelium
The current study presents a new observation regarding the possibility that obesity may be associated with dysregulation of epithelial gut function
Summary
Overweight and obesity are major risk factors for a number of chronic-degenerative diseases. It has been previously shown that in patients with short bowel syndrome, plasma citrulline is a biomarker for the severity of intestinal failure [3]. In several intestinal diseases there is an alteration of microflora which can play an important role in initiation of the disease. Another methodology to assess gut physiology is D-xylose test. The D-xylose test is an excellent serologic test for the diagnosis of important inflammatory intestinal conditions such as celiac disease [4]. Plasma citrulline concentration is a simple and reliable surrogate for small bowel absorptive capacity and is not influenced by intestinal inflammation
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