Association of diet with intestinal permeability and inflammation markers in patients with type 1 diabetes

Nutrition can affect gut dysbiosis and low-grade inflammation in type 1 diabetes (T1D). The present cross-sectional study aimed to explore the association between dietary factors and inflammatory and endotoxemia markers in patients with T1D. Participants completed a 24-h dietary recall, a 3-day food record and a food frequency questionnaire, and serum levels of inflammatory and endotoxemia markers, and fecal calprotectin levels were measured. In the T1D group, higher high-sensitivity C-reactive protein levels were associated with a higher intake of hot drinks (such as coffee, tea and cocoa) [OR, 3.95 (95% CI, 1.41-11.08), P=0.009] and legumes [OR, 4.91 (95% CI,1.38-17.41), P=0.014], and a lower intake of protein [OR, 0.27 (95% CI, 0.08-0.87), P=0.028], fat [OR, 0.29 (95% CI, 0.09-0.93), P=0.037], energy [OR, 0.26 (95% CI, 0.09-0.77), P=0.015] and fiber [OR, 0.34 (95% CI, 0.12-0.99), P=0.047]. Higher lipopolysaccharide (LPS) levels [OR, 2.07 (95% CI, 1.17-8.02), P=0.022]) and LPS/high-density lipoprotein ratio [OR, 2.71 (95% CI, 1.06-6.95), P=0.038] were associated with an increased consumption of red meat. In addition, fecal calprotectin levels were positively associated with higher protein consumption [OR, 3.37 (95% CI, 1.14-9.95), P=0.028]. In conclusion, the present exploratory study identified several associations between dietary choices and markers of intestinal permeability and inflammation in T1D, highlighting the need for further intervention studies investigating intestinal permeability.