Fasting and meal-related zonulin serum levels in a large cohort of obese children and adolescents.
Level 4 - case-series / case-control
Cross-sectional single-cohort observational study without a control group.
PubMed 38405153 · doi:10.3389/fendo.2024.1329363
What was done
Assessed fasting and post-challenge serum zonulin levels during an oral glucose tolerance test (OGTT at 0, 60, and 120 minutes) in 104 children and adolescents with obesity (BMI SDS ≥ 2.0; mean age 11.43 ± 2.66 years). Authors analyzed relationships between zonulin levels and BMI SDS, insulin resistance, liver steatosis assessed by ultrasound, and cardiometabolic parameters.
What was found
Impaired fasting glycaemia was present in 27.9%, impaired glucose tolerance in 11.5%, insulin resistance in 69.2%, and liver steatosis in 39.4% of the cohort. Serum zonulin significantly increased from baseline to the 60- and 120-minute OGTT time points. Serum zonulin at 120 minutes was positively correlated with BMI SDS, and fasting zonulin was positively associated with insulin resistance and glutamic-oxaloacetic transaminase (GOT) levels. No significant associations were observed for age, sex, pubertal status, glucose, or lipid profile (exact zonulin values, correlation coefficients, and p-values were omitted from the abstract).
Why it matters
This study provides initial evidence that circulating zonulin rises after an oral glucose load in pediatric obesity and correlates with markers of metabolic and liver dysfunction.
Limits
The study lacked a lean or healthy control group to establish whether postprandial zonulin dynamics differ in non-obese children. The cross-sectional design cannot establish causality between gut barrier integrity and insulin resistance, and key numerical values and effect sizes were not provided in the abstract.
Cited by
- supports Eating transiently increases intestinal permeability ('leaky gut').