The stool microbiota of insulin resistant women with recent gestational diabetes, a high risk group for type 2 diabetes

Fugmann, M; Breier, Michaela; Rottenkolber, Marietta; Banning, Friederike; Ferrari, Uta; Sacco, Vanessa; Grallert, Harald; Parhofer, Klaus G.; Seißler, Jochen; Clavel, Thomas; Lechner, Andreas

doi:10.1038/srep13212

Cited by 111 publications

(112 citation statements)

References 48 publications

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“…Previous research has linked this group to CVD risk factors including obesity 35, 36 and diabetes 37–39 , but the directions of reported associations have been inconsistent. For example, Furet and colleagues identified a decreased frequency of the Prevotella group in obese versus non-obese individuals.…”

Section: Discussionmentioning

confidence: 99%

Gut Microbiome Associates With Lifetime Cardiovascular Disease Risk Profile Among Bogalusa Heart Study Participants

Kelly

Bazzano

Ajami

et al. 2016

Circulation Research

281

214

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Rationale Few studies have systematically assessed the influence of gut microbiota on cardiovascular disease (CVD) risk. Objective To examine the association between gut microbiota and lifetime CVD risk profile among 55 Bogalusa Heart Study (BHS) participants with the highest and 57 with the lowest lifetime burdens of CVD risk factors. Methods and Results 16S rRNA sequencing was conducted on microbial DNA extracted from stool samples of the BHS participants. Alpha diversity, including measures of richness and evenness, and individual genera were tested for associations with lifetime CVD risk profile. Multivariable regression techniques were employed to adjust for age, gender, and race (Model 1), along with body mass index (BMI) (Model 2) and both BMI and diet (Model 3). In Model 1, odds ratios (95% confidence intervals) for each standard deviation increase in richness, measured by the number of observed operational taxonomic units, Chao 1 index, and abundance-based coverage estimator, were 0.62 (0.39, 0.99), 0.61 (0.38, 0.98), and 0.63 (0.39, 0.99), respectively. Associations were consistent in Models 2 and 3. Four genera were enriched among those with high versus low CVD risk profile in all models. Model 1 p-values were: 2.12×10−3, 7.95×10−5, 4.39×10−4, and 1.51×10−4 for Prevotella 2, Prevotella 7, Tyzzerella and Tyzzerella 4, respectively. Two genera were depleted among those with high versus low CVD risk profile in all models. Model 1 P-values were: 2.96×10−6 and 1.82×10−4 for Alloprevotella and Catenibacterium, respectively. Conclusions The current study identified associations of overall microbial richness and six microbial genera with lifetime CVD risk.

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Section: Discussionmentioning

confidence: 99%

Gut Microbiome Associates With Lifetime Cardiovascular Disease Risk Profile Among Bogalusa Heart Study Participants

Kelly

Bazzano

Ajami

et al. 2016

Circulation Research

281

214

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“…When members of both families co-occur in the gut, one or the other predominates because they have an antagonistic relationship (29). In fact, an inverse association between Bacteroidetes and Prevotella has been reported with obesity and type 2 diabetes in nonpregnant individuals (30,31) and now in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Connections Between the Gut Microbiome and Metabolic Hormones in Early Pregnancy in Overweight and Obese Women

et al. 2016

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Overweight and obese women are at a higher risk for gestational diabetes mellitus. The gut microbiome could modulate metabolic health and may affect insulin resistance and lipid metabolism. The aim of this study was to reveal relationships between gut microbiome composition and circulating metabolic hormones in overweight and obese pregnant women at 16 weeks' gestation. Fecal microbiota profiles from overweight (n = 29) and obese (n = 41) pregnant women were assessed by 16S rRNA sequencing. Fasting metabolic hormone (insulin, C-peptide, glucagon, incretin, and adipokine) concentrations were measured using multiplex ELISA. Metabolic hormone levels as well as microbiome profiles differed between overweight and obese women. Furthermore, changes in some metabolic hormone levels were correlated with alterations in the relative abundance of specific microbes. Adipokine levels were strongly correlated with Ruminococcaceae and Lachnospiraceae, which are dominant families in energy metabolism. Insulin was positively correlated with the genus Collinsella. Gastrointestinal polypeptide was positively correlated with the genus Coprococcus but negatively with family Ruminococcaceae. This study shows novel relationships between gut microbiome composition and the metabolic hormonal environment in overweight and obese pregnant women at 16 weeks' gestation. These results suggest that manipulation of the gut microbiome composition may influence pregnancy metabolism.The increasing prevalence of maternal obesity and its subsequent health outcomes are a significant public health concern and a major challenge for obstetrics practice. In early pregnancy, overweight and obese women are at an increased risk of metabolic complications that affect placental and embryonic development (1). Metabolic adjustments, such as a decline in insulin sensitivity and an increase in nutrient absorption, are necessary to support a healthy pregnancy (2,3); however, these metabolic changes occur on top of preexisting higher levels of insulin resistance in overweight and obese pregnant women, increasing the risk of overt hyperglycemia because of a lack of sufficient insulin secretion to compensate for the increased insulin resistance (3).The potential role of the gut microbiome (the composite of the bacteria present in the gastrointestinal tract) in pregnancy has become the subject of considerable interest. In normal pregnancy, the maternal gut microbiota changes from first to third trimester with a decline in butyrate-producing bacteria and an increase in Bifidobacteria, Proteobacteria, and lactic acid-producing bacteria. Inflammation and weight gain that occurs during pregnancy might be the result of microbe-driven processes to increase energy supply for the fetus (4). These alterations might also be linked with the maternal metabolic profile and thereby contribute to the development of pregnancy complications (5,6) as well as affect the metabolic and immunological health of the offspring (7). In summation, modifications in the metabolic hormone milieu du...

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“…Others found that the placental microbiota and microbiome differed between women with and without gestational diabetes 117. The stool microbiota of insulin resistant women with a history of gestational diabetes has been characterized postpartum, and women with former gestational diabetes had relatively higher abundance of the Prevotellaceae family as well as reduced abundance of Firmicutes, similar to the situation in type 2 diabetes 118. Another cross sectional study of the gut microbiome in women who had gestational diabetes and their offspring five years postpartum found no significant differences in gut microbiota between women who had gestational diabetes and controls, but some differences existed between offspring of women who had gestational diabetes and those who did not 119…”

Section: Emerging Treatmentsmentioning

confidence: 99%

Novel therapies for diabetes mellitus in pregnancy

Feghali

Scifres

2018

BMJ

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Diabetes is a common complication of pregnancy, and the prevalence of all types of the disease is increasing worldwide. Diabetes in pregnancy is associated with short term and long term adverse effects for mother and child. The goal of treatment of diabetes in pregnancy is to minimize maternal and fetal adverse events related to hyperglycemia. Treatment options vary by type of diabetes, from a focus on lifestyle modifications in gestational diabetes to continuous glucose monitoring and insulin pumps in pregestational diabetes. Nevertheless, given the commonality of hyperglycemia, considerable overlap exists in the treatment of different types of diabetes in pregnancy. Also, despite ongoing research on treatment of diabetes in pregnancy for decades, changes in the characteristics of the patient population have highlighted the limited effectiveness of different therapies. Specifically, despite the co-occurrence of obesity and diabetes, treatment recommendations including glycemic targets are not altered in such cases and a single optimal treatment strategy for each type of diabetes in pregnancy does not seem to exist. Rather, the approach to treating pregnant women with diabetes likely needs to be individualized to maximize the short term and long term health of mother and child. This article will review recent clinical studies to summarize established treatment strategies and introduce novel therapies for diabetes in pregnancy.

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The stool microbiota of insulin resistant women with recent gestational diabetes, a high risk group for type 2 diabetes

Cited by 111 publications

References 48 publications

Gut Microbiome Associates With Lifetime Cardiovascular Disease Risk Profile Among Bogalusa Heart Study Participants

Gut Microbiome Associates With Lifetime Cardiovascular Disease Risk Profile Among Bogalusa Heart Study Participants

Connections Between the Gut Microbiome and Metabolic Hormones in Early Pregnancy in Overweight and Obese Women

Novel therapies for diabetes mellitus in pregnancy

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