A microbiota‐based predictive model for type 2 diabetes remission induced by dietary intervention: From the CORDIOPREV study

• Published in: Clinical and translational medicine Vol. 11; no. 4; pp. e326 - n/a
• Main Authors: Vals‐Delgado, Cristina, Alcala‐Diaz, Juan F., Roncero‐Ramos, Irene, Leon‐Acuña, Ana, Molina‐Abril, Helena, Gutierrez‐Mariscal, Francisco M., Romero‐Cabrera, Juan L., Cruz‐Ares, Silvia, Ommen, Ben, Castaño, Justo P., Ordovas, Jose M., Perez‐Martinez, Pablo, Delgado‐Lista, Javier, Camargo, Antonio, Lopez‐Miranda, Jose
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.04.2021; John Wiley and Sons Inc; Wiley
• Subjects: Antibiotics; Biomarkers; Blood pressure; Body Mass Index; Body Weight; Calories; Cardiovascular disease; Cholesterol; Diabetes; Diabetes Mellitus, Type 2 - diet therapy; Diet, Fat-Restricted; Diet, Mediterranean; Feces; Female; Gastrointestinal Microbiome; Gastrointestinal surgery; Glucose; High density lipoprotein; Humans; Insulin resistance; Intervention; Letter to Editor; Low density lipoprotein; Male; Metabolism; Microbiota; Middle Aged; Remission (Medicine); Remission Induction - methods; Risk Reduction Behavior; Transient ischemic attack; Triglycerides; Waist Circumference
• ISSN: 2001-1326; 2001-1326
• DOI: 10.1002/ctm2.326

[...]the normalization of plasma glucose levels can occur in some patients just days after bariatric surgical intervention, and even before achieving significant weight loss.2 This observation points to a relevant glucoregulatory role of the gastrointestinal tract. [...]microbiome biomarkers could potentially be used to identify subjects who might benefit from specific dietary interventions.11 Our study, conducted in 110 newly diagnosed type 2 diabetes patients with coronary heart disease (CHD) within the Coronary Diet Intervention with Olive Oil and Cardiovascular Prevention (CORDIOPREV) study, evaluated whether baseline gut microbiota composition, in addition to the classic type 2 diabetes risk-associated variables, improves the identification of patients who underwent type 2 diabetes remission achieved by two dietary models (low-fat or Mediterranean diet) after a 5-year follow-up (responders, n = 44) and those who did not respond to the dietary intervention (nonresponders, n = 66), with both groups presenting the same adherence to both diets, and without promoting changes in lifestyle such as weight loss or medication. TABLE 1 Baseline characteristics of the newly diagnosed type 2 diabetes population for type 2 diabetes mellitus remission study and of the population with analyzed gut microbiota Responders Nonresponders Responders† Nonresponders† (n = 73) (n = 110) p value (n = 44) (n = 66) p value Men/women 60/13 92/18 0.799 36/8 56/10 0.674 Age (years) 60.8 ± 1.0 59.3 ± 0.9 0.252 60.1 ± 1.3 57.7 ± 1.2 0.198 Weight (kg) 80.2 ± 1.3 88.4 ± 1.4 <0.001 78.2 ± 1.7 88.0 ± 1.8 <0.001 Body mass index (kg/m2) 29.9 ± 0.4 32.1 ± 0.4 0.001 29.2 ± 0.6 31.7 ± 0.5 0.002 Waist circumference (cm) 101 ± 1 108 ± 1 <0.001 99 ± 1.3 108 ± 1.3 <0.001 Systolic blood pressure (mm Hg) 137 ± 3 138 ± 2 0.717 137 ± 3 135 ± 2 0.518 Diastolic blood pressure (mm Hg) 76.6 ± 1.6 77.1 ± 1.0 0.755 76.4 ± 2.1 76.5 ± 1.4 0.945 Triglycerides (mmol/L) 1.48 ± 0.10 1.69 ± 0.07 0.090 1.60 ± 0.15 1.71 ± 0.09 0.478 Total cholesterol (mmol/L) 4.16 ± 0.08 4.31 ± 0.08 0.203 4.24 ± 0.11 4.29 ± 0.11 0.726 HDL-cholesterol (mmol/L) 1.11 ± 0.03 1.06 ± 0.02 0.141 1.12 ± 0.05 1.04 ± 0.03 0.116 LDL cholesterol (mmol/L) 2.31 ± 0.07 2.42 ± 0.07 0.302 2.32 ± 0.10 2.35 ± 0.09 0.828 C-reactive protein (nmol/L) 37.1 ± 5.3 33.5 ± 3.6 0.558 37.8 ± 6.8 32.2 ± 4.5 0.480 HbA1c (mmol/mol) 47.8 ± 0.9 50.7 ± 0.9 0.032 48.1 ± 1.2 50.7 ± 1.3 0.176 HbA1c (%) 6.53 ± 0.08 6.79 ± 0.08 0.032 6.55 ± 0.11 6.79 ± 0.12 0.176 Glucose (mmol/L) 5.50 ± 0.09 6.58 ± 0.14 <0.001 5.59 ± 0.12 6.47 ± 0.20 0.001 Insulin (nmol/L) 64.4 ± 5.5 93.3 ± 7.8 0.007 64.8 ± 7.1 94.8 ± 11.9 0.058 HOMA-IR 3.49 ± 0.42 4.84 ± 0.32 0.010 3.93 ± 0.65 4.76 ± 0.45 0.281 Insulin sensitivity index 3.16 ± 0.20 2.37 ± 0.12 <0.001 3.02 ± 0.26 2.47 ± 0.16 0.063 Insulinogenic index 0.70 ± 0.19 0.68 ± 0.14 0.921 0.89 ± 0.26 0.80 ± 0.22 0.795 Hepatic insulin resistance index 1421 ± 168 1970 ± 129 0.009 1616 ± 263 1943 ± 182 0.293 Muscle insulin sensitivity index (×102) 1.93 ± 0.22 2.20 ± 0.25 0.452 1.74 ± 0.29 2.23 ± 0.35 0.313 Disposition index 0.68 ± 0.06 0.43 ± 0.02 <0.001 0.65 ± 0.05 0.46 ± 0.03 0.002 Smoking (%) 11.4 16.7 0.440 12.3 11.8 0.917 Hypertension (%) 57.5 65.5 0.279 61.4 60.6 0.936 History of peripheral vascular disease (%) 0.0 4.5 0.065 0.0 6.1 0.096 History of stroke or TIA (%) 4.1 4.5 0.888 4.5 4.5 1.000 History of myocardial infarction (%) 53.4 55.5 0.787 56.8 57.6 0.937 History of anginá (%) 40.0 39.7 0.970 38.6 36.4 0.809 History of PCI (%) 93.2 98.2 0.082 90.9 98.5 0.062 History of CABG (%) 5.5 2.7 0.342 6.8 1.5 0.146 Baseline medication (%) Anti-aggregates 94.5 96.4 0.550 95.5 100 0.080 Beta-blockers 57.5 65.5 0.279 56.8 68.2 0.225 ACE inhibitors 13.7 17.3 0.517 13.6 12.1 0.815 Diuretics 39.7 41.8 0.778 29.5 37.9 0.368 Angiotensin-II receptor blockers (ARBs) 20.5 23.6 0.624 22.7 19.7 0.702 Calcium antagonists 11.0 19.1 0.140 13.6 19.7 0.410 Nitrates 15.1 7.3 0.090 11.4 9.1 0.697 Anti-arrhythmics 2.7 0.9 0.340 2.3 1.5 0.771 Oral anticoagulants 1.4 0.9 0.769 0.0 1.5 0.412 Statins 86.3 88.2 0.707 95.5 95.5 1.000 Other hypolipidemics 6.8 7.3 0.913 6.8 6.1 0.873 Proton pump inhibitors 83.6 82.7 0.883 86.4 89.4 0.630 Tranquilizers 6.8 8.2 0.740 9.1 10.6 0.795 Abbreviations: CABG, coronary artery bypass grafting; PCI, percutaneous coronary intervention; TIA, transient ischemic attack. TABLE 2 Baseline characteristics of the newly diagnosed type 2 diabetes population for type 2 diabetes mellitus remission study compared with the population with analyzed gut microbiota Responders Responders† Nonresponders Nonresponders† (n = 73) (n = 44) p value (n = 110) (n = 66) p value Men/women 60/13 36/8 0.959 92/18 56/10 0.831 Age (years) 60.8 ± 1.0 60.1 ± 1.3 0.649 59.3 ± 0.9 57.7 ± 1.2 0.304 Weight (kg) 80.2 ± 1.3 78.2 ± 1.7 0.341 88.4 ± 1.4 88.0 ± 1.8 0.835 Body mass index (kg/m2) 29.9 ± 0.4 29.2 ± 0.6 0.361 32.1 ± 0.4 31.7 ± 0.5 0.639 Waist circumference (cm) 101 ± 1 99 ± 1 0.304 108 ± 1 108 ± 1 0.725 Triglycerides (mmol/L) 1.48 ± 0.10 1.60 ± 0.15 0.515 1.69 ± 0.07 1.71 ± 0.09 0.868 Total cholesterol (mmol/L) 4.16 ± 0.08 4.24 ± 0.11 0.543 4.31 ± 0.08 4.29 ± 0.11 0.895 HDL cholesterol (mmol/L) 1.11 ± 0.03 1.12 ± 0.05 0.838 1.06 ± 0.2 1.04 ± 0.03 0.667 LDL cholesterol (mmol/L) 2.31 ± 0.07 2.32 ± 0.10 0.916 2.42 ± 0.07 2.35 ± 0.09 0.570 C-reactive protein (nmol/L) 37.1 ± 5.3 37.8 ± 6.8 0.938 33.5 ± 3.6 32.2 ± 4.5 0.832 HbA1c (mmol/mol) 47.8 ± 0.9 48.1 ± 1.2 0.870 50.7 ± 0.9 50.7 ± 1.3 0.992 HbA1c (%) 6.53 ± 0.08 6.55 ± 0.11 0.870 6.79 ± 0.08 6.79 ± 0.12 0.992 Glucose (mmol/L) 5.50 ± 0.09 5.59 ± 0.12 0.561 6.58 ± 0.14 6.47 ± 0.20 0.649 Insulin (nmol/L)