Abstract

Background: Non-communicable diseases (NCDs) have become a major cause of morbidity and mortality in India. Perturbation of host–microbiome interactions may be a key mechanism by which lifestyle-related risk factors such as tobacco use, alcohol consumption, and physical inactivity may influence metabolic health. There is an urgent need to identify relevant dysmetabolic traits for predicting risk of metabolic disorders, such as diabetes, among susceptible Asian Indians where NCDs are a growing epidemic. Methods: Here, we report the first in-depth phenotypic study in which we prospectively enrolled 218 adults from urban and rural areas of Central India and used multiomic profiling to identify relationships between microbial taxa and circulating biomarkers of cardiometabolic risk. Assays included fecal microbiota analysis by 16S ribosomal RNA gene amplicon sequencing, quantification of serum short chain fatty acids by gas chromatography-mass spectrometry, and multiplex assaying of serum diabetic proteins, cytokines, chemokines, and multi-isotype antibodies. Sera was also analysed for N-glycans and immunoglobulin G Fc N-glycopeptides. Results: Multiple hallmarks of dysmetabolism were identified in urbanites and young overweight adults, the majority of whom did not have a known diagnosis of diabetes. Association analyses revealed several host–microbe and metabolic associations. Conclusions: Host–microbe and metabolic interactions are differentially shaped by body weight and geographic status in Central Indians. Further exploration of these links may help create a molecular-level map for estimating risk of developing metabolic disorders and designing early interventions.

Highlights

  • Whilst communicable diseases caused by infectious microbes continue to exert a significant public health burden in India, existing evidence indicates a marked shift to non-communicable diseases (NCDs) [1,2,3,4]

  • A survey of the medical records of the urban cohort revealed that 10.5% of participants had diabetes mellitus at enrolment

  • The urban Nagpurian cohort displayed significantly higher body mass index (BMI) compared to their rural counterparts (p < 0.001)

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Summary

Introduction

Whilst communicable diseases caused by infectious microbes continue to exert a significant public health burden in India, existing evidence indicates a marked shift to non-communicable diseases (NCDs) [1,2,3,4]. Metainflammation contributes to the development of many NCDs, including diabetes, which has increased rapidly in India over the last quarter of a century, rising from 26 million prevalent cases in 1990 to 65 million in 2016 [7]. The 9th Edition of the IDF Diabetes Atlas in 2019 reported that India is currently home to 77 million diabetics and this number is projected to soar to 134 million cases in the 25 years. A more recent study reported that 6 in 10 adults in large South Asian cities have either diabetes or prediabetes [10]. An Indian multistate study has reported that a high percentage of the diabetes cases in the Indian population remain undiagnosed, highlighting issues of poor awareness and detection of diabetes [11]. An important epidemiologic aim going forward will be to identify at-risk individuals, to facilitate an early therapeutic impact

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