Relation of Gut Lactobacillus Acidophilus and Atherosclerosis in type 2 diabetic patients with and without atherosclerosis

Abstract

Abstract: Background Recent researches show that alteration of GUT bacterial population is found to be an important factor for development of atherosclerosis either directly or indirectly through augmenting other known risk factors for atherosclerosis like; diabetes and dyslipidemia. On the other hand, many members of the gut microbiota are probiotics; Bifidobacterium and Lactobacillus are two well-known probiotics, many studies show their athero-protective role and their protective effect against insulin resistance and metabolic syndrome. Aim of the work To study the role of gut Lactobacillus Acidophilus in the development of atherosclerosis in type 2 diabetic patients (T2DM). Patients and methods The study was conducted on 64 type 2 diabetic patients, with their age ranging between 25 and 60 years old. They will be divided into two groups; Group 1: 32 Type 2 diabetic patients with atherosclerosis. Group 2: 32 Type 2 diabetic patients without atherosclerosis. All subjects in this study were subjected to Full medical history taking. Thorough clinical examination (including weight, height, BMI, blood pressure). The following laboratory investigations were done: Fasting blood glucose, two-hour post prandial, HbA1c, Fasting insulin (for HOMA IR), Lipid profile (Total cholesterol-LDL-HDL-Triglycerides), and Liver and kidney function test. Identification of stool Lactobacillus Acidophilus by Polymerase chain reaction (PCR) semi- quantitative technique. Carotid ultrasonography for estimation of intimamedia thickness (IMT). Results As regards PCR for Lactobacillus Acidophilus 68.8% of group one patients were positive for PCR for Lactobacillus Acidophilus, compared to 75.0% of group two, but there was no statistical difference among the two groups (P value = 0.578).As regards PCR cut-off time in PCR positive cases, there was a statistically significant difference among the two groups (P value= 0.016). Applying Receiver operating characteristic curve (ROC), it showed that PCR cut-off time more than 26.82 can be used as a predictor for atherosclerosis in type two diabetic patients (T2DM) with sensitivity of 72.73%, specificity of 70.83% and area under curve (AUC) of 0.723. In group one, there was a statistically significant positive correlation between PCR cut off time and the two hours post prandial blood sugar (P value= 0.005), the glycated hemoglobin (HBa1c) (P value= 0.049) and intimal media thickness (IMT) (P-value= 0.045). Conclusion Lactobacillus Acidophilus concentration is higher in type 2 diabetes patients without atherosclerosis than in atherosclerotic patients and detection of their level in stool using PCR can be used as a predictor for atherosclerosis in type two diabetes patients.