Взаємозв’язок порушень мікробіоценозу кишечника із сироватковим рівнем серотоніну у хворих на діабетичну ентеропатію

Objective — to investigate the interrelation between disorders of intestinal microbiocenosis and the level of serum serotonin in patients with type 2diabetes mellitus (DM 2). Materials and methods. The investigation has been performed on the basis of «Berezovyi Hai» sanatorium, a part of the sanatorium and spa complex of the Private Corporation «Mirgorodkurort». Observations involved 126 patients with DM 2 and diabetic enteropathy associated with syndrome of intestinal bacterial overgrowth (SIBO), 75 (59.5 %) of them were women and 51 (40.5 %) were men. The mean age was 56.90  ± 5.41 years, the mean DM 2 duration was 11.80 ± 2.91 years. Forthecarbohydrate disorders’ correction,allpatients received sugar-lowering therapy in stable doses for not less than 6 months. Depending on the clinically predominant constipation or diarrhea in the diabetic enteropathy, the patients were divided into 2 groups: group І (n  = 72)with constipation-predominant SIBO-associated enteropathy; group ІІ (n = 54) included subjects with DM 2 anddiarrhea-predominant SIBO-associated enteropathy. Thecontrolgroupincluded 22 practically healthy subjects, from them 12 (54.5 %) women and 10 (45.5 %) men with the mean age of 22.8 ± 3.1 years. The following assessments were perfumed to all patients:evaluation of carbohydrate metabolism based on fasting serum glucose level, postprandial glycaemia, C-peptide with the use of CGMSMMT-71002 WMedtronik (MiniMed, USA). Serum serotonin levels were determined with thehigh performance liquid chromatography on Agilent 1100 chromatograph (Agilent Technologies, USA). Themicrobiocenosisstatusin the large intestine was assessed by the stool bacteriogram. The evaluation of gastrointestinal complaints was performed with questioning. In the questionnaire, the patients had to register the complaints’ intensity and frequency over 24 hours and during a week. Results. In the patients of group II (predominant diarrhea), a higher intensity and frequency of abdominal pain onset were noted in comparison with group I (constipation-predominant patients), as well as increased serotonin serum levels in 2 times vs control group, and in 3.2 ties vs group I. The results of hydrogen breathtest in patients of group II (predominant diarrhea) showed the increased propulsive intestinal activity with the preserved function of ileocecal, that was accompanied with the significant reduction of the titer of bifidobacterial against the background of Escherichia coli titer and an increase of the opportunistic microflora level. Conclusions. In patients with DM type 2 and predominant diarrhea, the significant decrease of Bifidobacteria titer was established. It resulted in the increased effects of opportunistic microflora and, hence to the potentiating of inflammation in the intestinal wall with serotonin release activation.