Abstract

Aims/hypothesisThe gut microbiome is hypothesised to be related to insulin resistance and other metabolic variables. However, data from population-based studies are limited. We investigated associations between serologic measures of metabolic health and the gut microbiome in the Northern Finland Birth Cohort 1966 (NFBC1966) and the TwinsUK cohort.MethodsAmong 506 individuals from the NFBC1966 with available faecal microbiome (16S rRNA gene sequence) data, we estimated associations between gut microbiome diversity metrics and serologic levels of HOMA for insulin resistance (HOMA-IR), HbA1c and C-reactive protein (CRP) using multivariable linear regression models adjusted for sex, smoking status and BMI. Associations between gut microbiome diversity measures and HOMA-IR and CRP were replicated in 1140 adult participants from TwinsUK, with available faecal microbiome (16S rRNA gene sequence) data. For both cohorts, we used general linear models with a quasi-Poisson distribution and Microbiome Regression-based Kernel Association Test (MiRKAT) to estimate associations of metabolic variables with alpha- and beta diversity metrics, respectively, and generalised additive models for location scale and shape (GAMLSS) fitted with the zero-inflated beta distribution to identify taxa associated with the metabolic markers.ResultsIn NFBC1966, alpha diversity was lower in individuals with higher HOMA-IR with a mean of 74.4 (95% CI 70.7, 78.3) amplicon sequence variants (ASVs) for the first quartile of HOMA-IR and 66.6 (95% CI 62.9, 70.4) for the fourth quartile of HOMA-IR. Alpha diversity was also lower with higher HbA1c (number of ASVs and Shannon’s diversity, p < 0.001 and p = 0.003, respectively) and higher CRP (number of ASVs, p = 0.025), even after adjustment for BMI and other potential confounders. In TwinsUK, alpha diversity measures were also lower among participants with higher measures of HOMA-IR and CRP. When considering beta diversity measures, we found that microbial community profiles were associated with HOMA-IR in NFBC1966 and TwinsUK, using multivariate MiRKAT models, with binomial deviance dissimilarity p values of <0.001. In GAMLSS models, the relative abundances of individual genera Prevotella and Blautia were associated with HOMA-IR in both cohorts.Conclusions/interpretationOverall, higher levels of HOMA-IR, CRP and HbA1c were associated with lower microbiome diversity in both the NFBC1966 and TwinsUK cohorts, even after adjustment for BMI and other variables. These results from two distinct population-based cohorts provide evidence for an association between metabolic variables and gut microbial diversity. Further experimental and mechanistic insights are now needed to provide understanding of the potential causal mechanisms that may link the gut microbiota with metabolic health.Graphical abstract

Highlights

  • Obesity and type 2 diabetes have reached global epidemic proportions and are recognised as major causes of morbidity and mortality [1, 2]

  • The mean number of amplicon sequence variants (ASVs) was lower in the 4th quartile of HOMA for insulin resistance (HOMA-IR) (66.6, 95% CI 62.9, 70.4) compared with the 1st quartile (74.4, 95% CI 70.7, 78.3) (ESM Table 2)

  • Higher values of HOMA-IR were associated with higher presence of members of the Lachnospiraceae family and Veillonella in TwinsUK. In this analysis of gut microbiome profiles and metabolic variables in two population-based cohorts, higher levels of HOMA-IR, C-reactive protein (CRP) and HbA1c were associated with lower diversity of the gut microbiome, even after adjustment for BMI and other factors

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Summary

Introduction

Obesity and type 2 diabetes have reached global epidemic proportions and are recognised as major causes of morbidity and mortality [1, 2]. Despite the wellestablished epidemiological links between insulin resistance, its related variables (i.e., poor glucose control and high levels of inflammation) and chronic diseases including obesity and type 2 diabetes, the potential role of the gut microbiome in the development of insulin resistance and type 2 diabetes is not fully understood. Previous studies have suggested a link between the gut microbiome and metabolic health [6, 7], and have described differences of microbial composition and functionality in type 2 diabetes patients compared with healthy participants [7, 8]. The gut microbiome is potentially associated with host metabolic health through several pathways including energy extraction, intestinal barrier integrity, metabolism of bile acids and host metabolic and signalling pathways, which are directly or indirectly related to insulin resistance development [9]. Because of the cross-sectional nature of these studies, it is impossible to conclude whether these differences in microbial composition are a cause or a consequence of metabolic dysfunction

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