The Gut Microbiota in Prediabetes and Diabetes: A Population-Based Cross-Sectional Study

• Published in: Cell metabolism Vol. 32; no. 3; pp. 379 - 390.e3
• Main Authors: Wu, Hao, Tremaroli, Valentina, Schmidt, Caroline, Lundqvist, Annika, Olsson, Lisa M., Krämer, Manuela, Gummesson, Anders, Perkins, Rosie, Bergström, Göran, Bäckhed, Fredrik
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2020
• Subjects: biotin biosynthesis; butyrate producers; Cell Biology; combined glucose intolerance; dietary fiber; Endocrinology & Metabolism; Endocrinology and Diabetes; Endokrinologi och diabetes; fasting glucose; gut microbiome; gut microbiota; impaired fasting glucose; impaired glucose tolerance; individuals; insulin resistance; insulin sensitivity; intestinal microbiota; life-style; plasma-glucose; prediabetes; risk; type 2 diabetes; type-2; type 2 diabetes; gut microbiome; impaired fasting glucose; prediabetes; impaired glucose tolerance; combined glucose intolerance; insulin resistance; biotin biosynthesis; gut microbiota; butyrate producers
• ISSN: 1550-4131; 1932-7420; 1932-7420
• DOI: 10.1016/j.cmet.2020.06.011

The link between the gut microbiota and type 2 diabetes (T2D) warrants further investigation because of known confounding effects from antidiabetic treatment. Here, we profiled the gut microbiota in a discovery (n = 1,011) and validation (n = 484) cohort comprising Swedish subjects naive for diabetes treatment and grouped by glycemic status. We observed that overall gut microbiota composition was altered in groups with impaired glucose tolerance, combined glucose intolerance and T2D, but not in those with impaired fasting glucose. In addition, the abundance of several butyrate producers and functional potential for butyrate production were decreased both in prediabetes and T2D groups. Multivariate analyses and machine learning microbiome models indicated that insulin resistance was strongly associated with microbial variations. Therefore, our study indicates that the gut microbiota represents an important modifiable factor to consider when developing precision medicine approaches for the prevention and/or delay of T2D. [Display omitted] •The overall gut microbiota shifts in parallel with glycemic status in humans•The shifts are observed in the absence of diabetes treatment•The variations strongly associate with insulin resistance, but not fasting glucose•Butyrate-producing bacteria are reduced in prediabetes and type 2 diabetes Type 2 diabetes is associated with an altered gut microbiota, but the results may have been confounded by metformin medication. Wu et al. now use two populations encompassing almost 1,500 subjects to demonstrate that the gut microbiota is altered in prediabetes and diabetes independent of diabetes medication.