Intestinal Endotoxemia and Beta- Cell Dysfunction in Prediabetics

Primary Objective : To determine the correlation between intestinal endotoxemia (measured by serum LBP) and basal beta-cell dysfunction (HOMA-B) in lean prediabetic patients with minimal insulin resistance (HOMA-IR <1.5).

Secondary Objectives:

• Compare endotoxemia levels (LBP) between lean prediabetic (HOMA-IR <1.5) and healthy controls.
• Evaluate LBP's association with fasting glucose and insulin in beta-cell dysfunction phenotype.

Hypothesis:

In lean prediabetes with beta-cell dysfunction (HOMA-IR <1.5), serum LBP levels correlate significantly with HOMA-B, indicating endotoxemia-driven beta-cell impairment.

Inclusion criteria

• Age: 18-65 years
• BMI: 18.5-24.9 kg/m²
• ADA prediabetes: FPG 100-125 mg/dL OR 2hPG 140-199 mg/dL OR HbA1c 5.7-6.4%
• HOMA-IR <1.5 (key inclusion criterion)

Exclusion criteria

• - HOMA-IR ≥1.5
• BMI ≥25 kg/m²
• Diabetes, acute inflammation, GI disorders (Table 1) Group II (Controls): Lean normoglycemic ; age and sex-matched healthy subjects