New Insights on Obesity and Diabetes from Gut Microbiome Alterations in Egyptian Adults

Salah, Mohammed; Azab, Marwa; Ramadan, Ahmed; Hanora, Amro

doi:10.1089/omi.2019.0063

Cited by 35 publications

(43 citation statements)

References 55 publications

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“…Fusobacterium is a typical colorectal cancer-related pathogen [ 27 , 28 ]. Fusobacterium was also found to be more abundant in diabetes patients than in non-diabetic subjects [ 29 , 30 ]; as such, the role of Fusobacterium concerning the pathogenesis of RT2D needs further study. Veillonella is a gram-negative anaerobic cocci that normally resides in the gastrointestinal tract, oral cavity and vagina [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Akkermansia muciniphila is Negatively Correlated with Hemoglobin A1c in Refractory Diabetes

et al. 2020

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Patients with refractory diabetes are defined as type 2 diabetes (T2D) patients; they cannot achieve optimal glycemic control and exhibit persistent elevations of hemoglobin A1c (HbA1c) ≥8% while on appropriate therapy. Hyperglycemia can lead to severe microvascular/macrovascular complications. However, in contrast to T2D, few studies have focused specifically on the gut microbiota in refractory diabetes. To examine this issue, we recruited 79 subjects with T2D and refractory diabetes (RT2D), and all subjects received standard therapy with Metformin or other hypoglycemic agents with or without insulin for at least one year. The α-diversity displayed no significant difference, whereas the β-diversity showed a marginal significance (p = 0.054) between T2D and RT2D. The evaluation of taxonomic indices revealed reductions in both Akkermansia muciniphila and Fusobacterium and a corresponding enrichment of Bacteroides vulgatus, Veillonella denticariosi among those with RT2D. These microbial markers distinguished RT2D from T2D with an acceptable degree of discrimination (area under the curve (AUC) = 0.719, p < 0.01) and were involved in several glucose-related functional pathways. Furthermore, the relative abundance of Akkermansia muciniphila was negatively correlated with HbA1c. Our combined results reveal unique features of the gut microbiota in RT2D and suggest that the evaluation of the gut microbiota could provide insights into the mechanisms underlying glycemic control and the impact of therapeutic modalities in patients with RT2D.

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Section: Discussionmentioning

confidence: 99%

Akkermansia muciniphila is Negatively Correlated with Hemoglobin A1c in Refractory Diabetes

et al. 2020

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“…Based on our results we hypothesize that dysbiosis and disruption of the Firmicutes / Bacteroidetes ratio may have more impact on diabetes than the presence of a specific bacterial taxa. This dysbiosis is observed in many metabolic disorders such as obesity and diabetes [ 36 , 37 ]. Several studies have reported microbial signature in TIID.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the previous studies, a study done on Egyptian citizens, by Salah et al . [ 37 ] concluded that obesity and diabetes were associated with enriched populations of both Firmicutes and Bacteroidetes. This could be explained by the type of diet, high carbohydrate intake and is correlated with high populations of Firmicutes and Bacteroidetes, while high fat diet is correlated withhigh abundance of Firmicutes only.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of the gut microbiome in Egyptian patients with Type I and Type II diabetes

et al. 2020

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Introduction Diabetes remains a growing public health concern in Egypt, as prevalence of Type II diabetes (TIID) has nearly tripled there in the last two decades. Egypt was ranked ninth worldwide in number of diabetes cases, with prevalence of 15.56% among adults. Recent studies have proposed that disturbance of gut microbiota could influence TIID development and indicated associations between a reduced diversity in microbiomes and Type I diabetes (TID). In the present study, we investigated the composition and abundance of the bacterial microbiome in disease state (TID and TIID) of Egyptian patients. Our goal in this study was to characterize features of the gut microbiota and possible differences associated with TID and TIID in this population. Methods DNA was extracted from fecal samples taken from 22 TID and 18 TIID outpatients of Al-Hussein hospital, Cairo, Egypt. 16S rRNA amplicon sequencing was used to characterize the bacterial taxa and these reads were processed using the software mothur with analysis utilizing packages vegan, phyloseq and metagenomSeq in R. Results and conclusions Our results highlighted a significant increase in abundance of Gram negative, potentially opportunistic pathogenic taxa (Pseudomonas, Prevotella) in all diabetic groups, compared to the control. Lipopolysccharide (LPS), a component of the gram-negative bacterial wall, can activate local immune response and may result in low-grade systemic inflammation contributing to insulin resistance. The gram-positive Gemella, which is associated with increased risk to diabetes, also had a significant increase in abundance in all diabetic groups, compared to the control. In contrast, the commensal bacterial taxa Turicibacter, Terrisporobacter and Clostridium were found to be more abundant in the control group than

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“…In addition, we found that the F/B ratio was decreased after the intervention compared with that before the intervention. Some studies have suggested that Bacteroides and Firmicutes are markers of obesity, with animal models showing that the F/B ratio is higher in obese than in normal weight animals ( 5 , 43 , 44 ). Through our analyses of bacterial diversity and species abundance, we found that 6 weeks of exercise and diet intervention not only increased the intestinal microbial diversity of adolescents with obesity but also markedly changed the abundance of their intestinal bacterial flora.…”

Section: Discussionmentioning

confidence: 99%

Six-Week Exercise Training With Dietary Restriction Improves Central Hemodynamics Associated With Altered Gut Microbiota in Adolescents With Obesity

et al. 2020

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PurposeObesity in children and in adolescents can lead to adult cardiovascular diseases, and the gut microbiota plays a crucial role in obesity pathophysiology. Exercise and diet interventions are typical approaches to improve physical condition and to alter the gut microbiota in individuals with obesity. However, whether central hemodynamic parameters including subendocardial viability ratio, the augmentation index standardized to a heart rate of 75/min (AIx75), resting heart rate, and blood pressure, correlate with gut microbiota changes associated with exercise and diet is unclear.MethodsAdolescents (n = 24, 12.88 ± 0.41 years) with obesity completed our 6-week program of endurance and strength exercises along with dietary restriction. Blood and fecal samples were collected, and physical parameters were measured before and 24 h after the last session of the intervention program. Pulse wave analysis using applanation tonometry provided the subendocardial viability ratio, a surrogate measure of microvascular myocardial perfusion, and AIx75, a measure of arterial stiffness and peripheral arteriolar resistance. Correlation analysis detected any associations of anthropometric or central hemodynamic parameters with gut microbiome composition.ResultsExercise and diet interventions significantly reduced body weight, body mass index, body fat, and waist-to-hip ratio, and lowered levels of fasting blood glucose, serum triglycerides, and high-density lipoprotein cholesterol. AIx75 and resting heart rate were also significantly reduced after the intervention without changes to systolic or diastolic blood pressure. The ratio of intestinal microbiota Firmicutes to Bacteroidetes displayed a marked increase after intervention. Interventional changes in gut microbiota members were significantly associated with anthropometric and metabolic parameters. Microbial changes were also significantly correlated with central hemodynamic parameters, including subendocardial viability ratio, AIx75, and resting heart rate.ConclusionExercise and diet interventions significantly improved measures of central hemodynamics, including subendocardial viability ratio, AIx75, and resting heart rate, which were correlated with altered gut microbiota in adolescents with obesity. Our findings shed light on the effects and mechanisms underlying exercise and diet interventions on obesity and suggest this approach for treating patients with both cardiovascular disease and obesity.

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New Insights on Obesity and Diabetes from Gut Microbiome Alterations in Egyptian Adults

Cited by 35 publications

References 55 publications

Akkermansia muciniphila is Negatively Correlated with Hemoglobin A1c in Refractory Diabetes

Akkermansia muciniphila is Negatively Correlated with Hemoglobin A1c in Refractory Diabetes

A comparative study of the gut microbiome in Egyptian patients with Type I and Type II diabetes

Six-Week Exercise Training With Dietary Restriction Improves Central Hemodynamics Associated With Altered Gut Microbiota in Adolescents With Obesity

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