| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 2121082 | EBioMedicine | 2016 | 8 Pages |
•Diabetes patients have very low levels of intestinal alkaline phosphatase (IAP) in their stool.•Obese people with high IAP do not develop diabetes.•A low level of IAP in a healthy person is indicative of having the incipient (latent) metabolic syndrome (diabetes).•Approximately 65% of the healthy population have the incipient metabolic syndrome including incipient diabetes.•‘Temporal IAP profiling’ should diagnose the incipient metabolic syndrome (diabetes).Currently, diabetes is diagnosed by high blood sugar, for example having fasting plasma glucose (FPG) > 7.0 mmol/l. High FPG is associated only with already established diabetes, and therefore FPG cannot predict years in advance whether a person have incipient (latent) diabetes. This study shows that diabetes patients have very low levels of the gut enzyme intestinal alkaline phosphatase (IAP) in their stool indicating a protective role of IAP against diabetes. Even obese people do not develop diabetes if their IAP levels are high. Approx. 65% of healthy people have low IAP suggesting that these people have the incipient (latent) metabolic syndrome including incipient diabetes, and are very vulnerable to develop diabetes and other metabolic disorders in the near future. The study suggests that regular monitoring of stool IAP (temporal IAP profiling) might be very helpful to diagnose ‘incipient’ diabetes, the metabolic syndrome and other metabolic disorders.
Mice deficient in intestinal alkaline phosphatase (IAP) develop type 2 diabetes mellitus (T2DM). We hypothesized that a high level of IAP might be protective against T2DM in humans. We determined IAP levels in the stools of 202 diabetic patients and 445 healthy non-diabetic control people. We found that compared to controls, T2DM patients have approx. 50% less IAP (mean +/− SEM: 67.4 +/− 3.2 vs 35.3 +/− 2.5 U/g stool, respectively; p < 0.000001) indicating a protective role of IAP against T2DM. Multiple logistic regression analyses showed an independent association between the IAP level and diabetes status. With each 25 U/g decrease in stool IAP, there is a 35% increased risk of diabetes. The study revealed that obese people with high IAP (approx. 65 U/g stool) do not develop T2DM. Approx. 65% of the healthy population have < 65.0 U/g stool IAP, and predictably, these people might have ‘the incipient metabolic syndrome’, including ‘incipient diabetes’, and might develop T2DM and other metabolic disorders in the near future. In conclusion, high IAP levels appear to be protective against diabetes irrespective of obesity, and a ‘temporal IAP profile’ might be a valuable tool for predicting ‘the incipient metabolic syndrome’, including ‘incipient diabetes’.
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