Gut microbiome may predict and improve treatment of Type 2 diabetes

Several common taxa in the gut microbiome are associated with incident type 2 diabetes (T2D), according to a study in Diabetes Care.

Investigators analyzed the long-term association between gut microbiome composition and incident T2D in a well-phenotyped and representative Finnish population from the FINRISK 2002 cohort.

The researchers conducted feature selection separately in data from eastern Finland and evaluated the findings in participants from western Finland to establish robust microbial signals predictive of incident T2D.

Participants’ health status was assessed at baseline in 2002 and were followed through December 31, 2017. A total of 5572 participants were included; their mean age was 48.7±12.8 years, and 54.1% were women.

After a median follow-up of 15.8 years, 432 (7.8%) participants were diagnosed with T2D. Of the 119 taxa remaining after filtering data from the eastern Finland group, the relative abundances of 18 taxa were significantly associated with incident T2D (adjusted P < .05).

In the western Finland subpopulation, 4 taxa and 2 clusters were positively associated with incident T2D. The taxa were Clostridium citroniae (eastern Finland: hazard ratio [HR] 1.21 [95% CI, 1.09-1.35]; western Finland: HR 1.21 [95% CI, 1.04-1.42; unadjusted P = .02]; C bolteae (eastern Finland: HR 1.18 [95% CI, 1.07-1.30]; western Finland: HR 1.20 [95% CI, 1.04-1.39; unadjusted P = .01]; Tyzzerella nexilis (eastern Finland: HR 1.16 [95% CI, 1.05-1.29]; western Finland: HR 1.17 [95% CI, 1.01-1.36] unadjusted P = .03); and Ruminococcus gnavus (eastern Finland: HR 1.18 [95% CI, 1.06-1.30]; western Finland: HR 1.17 [95% CI, 1.01-1.36; unadjusted P = .04].

C citroniae, C boltae, and R gnavus were grouped in cluster 1 (western Finland: HR 1.18 [95% CI, 1.02-1.38; unadjusted P = .03]) with Eggerthella lenta, which was not associated with T2D in the western Finland population as an individual predictor. T nexilis was grouped in cluster 5 (western Finland: HR 1.18; 95% CI,1.02-1.36; unadjusted P = .03) with 2 additional taxa in the cluster, C symbiosum and C glycyrrhizinilyticum, which were not individually associated with T2D in the data from western Finland.

The investigators noted that their findings may not be generalizable to other countries and that use of shallow shotgun metagenomics allows only a description of associations between taxa and incident disease.

“Additional experiments in humans and animal models could likely establish the required mechanistic and causal evidence to link specific microbial species and strains conclusively to type 2 diabetes pathogenesis,” stated the researchers. “The current study thus serves as a stepping stone toward the goal of improved prediction and the development of effective treatments for type 2 diabetes through modification of the gut microbiome.”

Disclosure: This research was supported in part by Illumina, Inc, and Janssen Pharmaceuticals through their sponsorship of the Center for Microbiome Innovation at the University of California San Diego. Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.