Evaluation of the relationship between serum zonulin levels and insulin resistance and blood lipid parameters

Insulin resistance is defined as the inability to show its biological effects despite sufficient insulin being produced and circulating. Insulin resistance, which involves cardiovascular risks, is a metabolic disease that is emphasized in this respect. In the light of recent studies, intestinal microbiota has been included among the factors responsible for insulin resistance, such as physical inactivity, unbalanced nutrition and obesity. Changes in the intestinal microbiota also cause problems in intestinal permeability. In this study; It was aimed to contribute to elucidating the role of intestinal permeability in the pathophysiology of insulin resistance and to observe whether there would be an improvement in insulin resistance with a decrease in intestinal permeability and serum zonulin level after an adequate and balanced diet. In our study, serums of women with insulin resistance and healthy women were collected. In addition, post-diet serum was collected from the insulin-resistant group and the group that received 6-week diet treatment. Zonulin levels were analyzed by ELISA method. A significant difference was detected in zonulin levels between groups and in women who received diet therapy before and after the diet. Correlation analysis was performed between Zonulin and laboratory parameters (glucose, insulin, cholesterol, triglyceride, HDL, LDL, ALT, AST) and HOMA-IR index values ​​calculated to indicate insulin resistance. Zonulin level was found to be higher in the insulin resistant group than in the healthy group. Pre-diet zonulin levels were found to be higher in insulin-resistant patients on diet therapy than before the diet. In the correlation analysis, zonulin; A strong positive correlation was found between insulin and HOMA-IR index, a moderate positive correlation with weight and BMI, and a weak positive correlation with age, calories, triglyceride, ALT and AST. No correlation was found with cholesterol, HDL and LDL. In the correlation study after diet treatment, a strong positive correlation was found between zonulin and insulin, and a moderate positive correlation with the HOMA-IR index. No correlation was detected with other laboratory parameters. The results of our study showed that increased zonulin levels may be associated with insulin resistance as a result of impaired intestinal permeability. Therefore, we think that zonulin can be used as an important biomarker in insulin resistant patients. We can predict that with the decrease in zonulin level observed after an adequate and balanced diet, the improvement in insulin resistance and the frequency of development of DM and cardiovascular diseases that may be caused by insulin resistance may decrease.