BACKGROUND
In recent years, special attention has been paid to the role of endotoxemia in the pathogenesis of chronic inflammatory processes and vascular complications of type 1 diabetes mellitus (DM1) — increased levels of circulating bacterial lipopolysaccharide (LPS). Endotoxemia occurs due to increased permeability of the intestinal barrier (“leaky gut syndrome”) and/or decreased activity of its elimination systems. Correction of endotoxemia is a promising direction in the complex therapy of DM1. Traditional approaches include strict glycemic control and the use of certain pharmacological agents, however, the search for effective non-pharmacological methods, such as the use of natural mineral waters, remains relevant. Despite the theoretical background, data on the effect of a course of mineral water intake on markers of endotoxemia and systemic inflammation in patients with DM1 are extremely limited.
AIMS:
to evaluate the effect of mineral waters on the state of LPS-binding systems, the level of circulating lipopolysaccharide and markers of inflammation in patients with type 1 diabetes mellitus.
MATERIAL AND METHODS
The study included 53 patients with a verified diagnosis of type 1 diabetes mellitus. The intervention group (n=25), in addition to standard DM1 therapy, received non-carbonated therapeutic table mineral water “Krymskaya mineralnaya” produced by JSC “Beer and Alcohol Plant “Crimea” for 150—200 ml 3 r/d. The second group was a control group, and consisted of 28 patients who were comparable in gender and age to the experimental group. ELISA kits were used to determine the level of C-reactive protein (CRP), interleukin-6 (IL-6), zonulin, lipopolysaccharide (LPS), lipopolysaccharide-binding protein (LBP), and low-density lipoproteins (LDL), including apolipoprotein B-100 (apoB-100) manufactured by Cloud Clone Corp. (Wuhan, Hubei, China).
RESULTS
In patients of group 1, after the use of mineral waters, a significant decrease in circulating LPS (p=0.029) and apoB-100 (p=0.002) was detected, as well as a statistically significant increase in LBP (p=0.009). There were no significant changes in the studied indicators in the control group.
CONCLUSIONS
The study demonstrates that a 30-day course of taking “Krymskaya” mineral water in addition to standard insulin therapy in patients with type 1 diabetes mellitus leads to a statistically significant decrease in the level of circulating lipopolysaccharide (LPS), a key trigger of endotoxemia and chronic inflammation. The results obtained justify the expediency of further studying the use of mineral waters, in particular bicarbonate-chloride-sodium, as a component of complex non-pharmacological therapy aimed at correcting endotoxemia and improving the metabolic profile in patients with type 1 diabetes mellitus.
