Sviluppo di un metodo in elettroforesi capillare per la determinazione del lattulosio e del mannitolo nelle urine e sue applicazioni allo studio della permeabilità intestinale in diabetici di tipo 1

Development of a capillary electrophoresis method for urinary lactulose and mannitol determination to assess the intestinal permeability in patients with type 1 diabetes. The assessment of the unbalanced intestinal permeability to lactulose (LAC) and mannitol (MAN) after oral administration is used for the diagnosis of gluten-sensitive enteropathy. Aim of this study was to set up a method by capillary electrophoresis to detect the concentration of MAN and LAC in urine to estimate the intestinal permeability in controls and in patients affected by type I diabetes mellitus. In <10 min the underivatized carbohydrates were separated at pH of 12.5 and with indirect UV detection at 254 nm. In controls (n=41) 11.3 (median; interquartile range: 5.7-15.3) and 303 (237-440) mg of LAC and MAN were excreted during the 5 h urine collection after the carbohydrate administration, while in diabetes patients (n=24) 16.5 (12.8-24.3) and 229 (170-354) mg of LAC and MAN were found. This simple and rapid technique is suitable to study intestinal permeability alterations in different cohorts of patients