TITLE:
Plasma Citrulline: A New Marker of Gut Epithelium Alteration in Obese Patients?
AUTHORS:
Stefano Benedini, Isabella Fermo, Andrea Caumo, Ileana Terruzzi, Livio Luzi
KEYWORDS:
Citrulline, Obesity, HOMA-IR, Gut
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.5 No.4,
October
28,
2015
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.