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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/220497
Biomarkers of Oxidation, Inflammation and Intestinal Permeability in Persons with Diabetes Mellitus with Parenteral Nutrition: a Multicenter Randomized Trial
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Background and aims: Parenteral nutrition (PN) composition could play a role in the management of systemic inflammatory response and intestinal barrier disruption. We aimed to evaluate changes in biomarkers of inflammation, oxidative status and intestinal permeability in patients with type 2 diabetes mellitus (T2DM) who received different PN lipid formulas. Methods: This was a prospective study, including 94 patients with T2DM who received omega (n)-3 polyunsaturated fatty acids (PUFA)-enriched PN, a mixture of medium and long chain triglycerides (MCT/ LCT) PN, or an olive oil-based PN. Serum levels of biomarkers of oxidative status, intestinal permeability and inflammation biomarkers were determined at day 1 and day 5 after PN initiation. Registered under ClinicalTrials.gov Identifier no. NCT02706119. Results: At day 5 after the onset of PN, the MCT/LCT group had a significant reduction of 2 proinflammatory cytokines [interleukin (IL)-15, IL-17A], elevation of the anti-inflammatory cytokine IL-13 and increase of zonulin and indoxylsulfate. The olive oil group showed a statistically significant reduction of 5 proinflammatory cytokines [IL-1D, IL-17A, IL-6, cytokine-leukemia inhibitory factor (LIF) and tumor necrosis factor alpha (TNF-a)] and reduced concentrations of the anti-inflammatory cytokine IL-1RA, while the n-3 PUFA-enriched group presented a statistically significant reduction of 8 proinflammatory cytokines (interferon-gamma, IL-1D, IL-15, IL-17A, IL-6, LIF, monocyte chemoattractant protein 1, and TNF-a). In the between-group comparisons, indoxylsulfate significantly increased in the MCT/LCT group compared to the n-3 PUFA-enriched group, while 8-isoprostane and indoxylsulfate significantly increased in the MCT/LCT group compared to the other groups and superoxide dismutase significantly decreased in the MCT/LCT group compared to the other groups. Conclusion: In patients with T2DM, PN lipid composition exerts a profound impact on proinflammatory, prooxidative and intestinal permeability biomarkers.
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SORIA UTRILLA, Virginia, et al. Biomarkers of Oxidation, Inflammation and Intestinal Permeability in Persons with Diabetes Mellitus with Parenteral Nutrition: a Multicenter Randomized Trial. Clinical Nutrition. 2025. Vol. 44, num. 155-164. ISSN 0261-5614. [consulted: 14 of June of 2026]. Available at: https://hdl.handle.net/2445/220497