1361-P: D-Xylose Test as a Biomarker for Glucose Intestinal Absorption in Humans and Minipigs

Background and Aim: Increasing evidences suggest that intestinal glucose absorption (IGA) plays a distinct role in pathophysiology of type 2 diabetes (T2D) . However, state of the art IGA measurement with multiple tracers techniques are demanding and . We propose D-xylose, a non metabolized pentose, as a proxy to quantify IGA levels to study IGA involvement in T2D.

Materials and Methods: First (cross sectional studies) , mixed meal tests including D-xylose (MMT) were performed in 165 patients (lean normoglycemic (NG) ; obese NG, glucose intolerant (IGT) or T2D) and 74 healthy adult minipigs. Second (longitudinal studies) , MMT were performed in minipigs before and after 70% intestinal resection (n = 5) , 70% pancreatectomy (n = 15) , and high fat diet for 2 months (HFD) (n = 4) to quantify D-xylose changes after each intervention.

Results: 1h serum D-xylose varied with glucose tolerance status (p<0.005) and was higher in T2D and IGT patients than in obese and lean NG patients In multivariable analysis, 1h postprandial glucose was correlated with D-xylose (r= 0.63; p<0.0001) , independently of insulin secretion (insulinogenic index) and insulin sensitivity (Matsuda index) . In minipigs, D-xylose was also independently correlated with post prandial glucose (r=0.53; p<0.05) . D-xylose appearance was reduced after intestinal resection (p<0.05) , but remained unchanged after pancreatectomy and HFD.

Conclusion and Perspectives: Post prandial glucose was independently correlated with D-xylose in humans and minipigs. Interventional studies in minipigs provided direct evidence that D-xylose is associated with IGA, independently of insulin secretion and sensitivity.