Lipopolysaccharide-binding systems in the pathogenesis of vascular complications in patients with type 1 diabetes mellitus

Rationale. Disturbance of glycemia in type 1 diabetes mellitus (DM1) leads to the development of oxidative stress and damage to the barrier organs for lipopolysaccharide (LPS), which is accompanied by its increased translocation into the systemic bloodstream, inducing vascular damage.
The aim. Determination of the influence of the level of major lipopolysaccharidebinding systems on the risk of macro- and microvascular complications of DM1.
Materials and methods. The study included 92 patients with a verified diagnosis of type 1 diabetes mellitus. Patients underwent examination of biomaterial (blood plasma) by enzyme-linked immunosorbent assay (ELISA) to determine the level of lipopolysaccharide-binding protein (LBP), bactericidal permeability-increasing protein (BPI) and sCD14, as well as a marker of systemic inflammation – CRP. ROC-analysis with ROC-curve construction was used to assess the quality of the prognostic model efficiency, as well as to find the optimal point (cut-off point) of the threshold value of the level of the investigated markers.
Results. ROC-analysis revealed statistically significant patterns of relationship between peripheral blood LBP level and risk of arterial hypertension (AH) in patients with DM1 (p = 0.014), as well as relationship between peripheral blood LBP and sCD14 level and risk of diabetic nephropathy (DN) in patients with DM1 (p = 0.042 and p = 0.048).
Conclusion. We have revealed a statistically significant influence of LBP and sCD14 concentrations on the development of vascular lesions in DM1, with a decrease in the level of the main LPS-binding systems accompanied by an increased risk of AH and DN. Lipopolysaccharide of Gram-negative flora plays an important role in the development of complications of DM1, which is largely due to the peculiarities of the response to LPS under conditions of hyperglycemia and dysfunction of the normal response to LPS, accompanied by protective reactions and subsequent clearance of LPS.

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