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Nogal A, Tettamanzi F, Dong Q, Louca P, Visconti A, Christiansen C, Breuninger T, Linseisen J, Grallert H, Wawro N, Asnicar F, Wong K, Baleanu AF, Michelotti GA, Segata N, Falchi M, Peters A, Franks PW, Bagnardi V, Spector TD, Bell JT, Gieger C, Valdes AM, Menni C. A Fecal Metabolite Signature of Impaired Fasting Glucose: Results From Two Independent Population-Based Cohorts. Diabetes 2023; 72:1870-1880. [PMID: 37699401 PMCID: PMC10658071 DOI: 10.2337/db23-0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Abstract
Prediabetes is a metabolic condition associated with gut microbiome composition, although mechanisms remain elusive. We searched for fecal metabolites, a readout of gut microbiome function, associated with impaired fasting glucose (IFG) in 142 individuals with IFG and 1,105 healthy individuals from the UK Adult Twin Registry (TwinsUK). We used the Cooperative Health Research in the Region of Augsburg (KORA) cohort (318 IFG individuals, 689 healthy individuals) to replicate our findings. We linearly combined eight IFG-positively associated metabolites (1-methylxantine, nicotinate, glucuronate, uridine, cholesterol, serine, caffeine, and protoporphyrin IX) into an IFG-metabolite score, which was significantly associated with higher odds ratios (ORs) for IFG (TwinsUK: OR 3.9 [95% CI 3.02-5.02], P < 0.0001, KORA: OR 1.3 [95% CI 1.16-1.52], P < 0.0001) and incident type 2 diabetes (T2D; TwinsUK: hazard ratio 4 [95% CI 1.97-8], P = 0.0002). Although these are host-produced metabolites, we found that the gut microbiome is strongly associated with their fecal levels (area under the curve >70%). Abundances of Faecalibacillus intestinalis, Dorea formicigenerans, Ruminococcus torques, and Dorea sp. AF24-7LB were positively associated with IFG, and such associations were partially mediated by 1-methylxanthine and nicotinate (variance accounted for mean 14.4% [SD 5.1], P < 0.05). Our results suggest that the gut microbiome is linked to prediabetes not only via the production of microbial metabolites but also by affecting intestinal absorption/excretion of host-produced metabolites and xenobiotics, which are correlated with the risk of IFG. Fecal metabolites enable modeling of another mechanism of gut microbiome effect on prediabetes and T2D onset. ARTICLE HIGHLIGHTS Prediabetes is a metabolic condition associated with gut microbiome composition, although mechanisms remain elusive. We investigated whether there is a fecal metabolite signature of impaired fasting glucose (IFG) and the possible underlying mechanisms of action. We identified a fecal metabolite signature of IFG associated with prevalent IFG in two independent cohorts and incident type 2 diabetes in a subanalysis. Although the signature consists of metabolites of nonmicrobial origin, it is strongly correlated with gut microbiome composition. Fecal metabolites enable modeling of another mechanism of gut microbiome effect on prediabetes by affecting intestinal absorption or excretion of host compounds and xenobiotics.
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Affiliation(s)
- Ana Nogal
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | - Francesca Tettamanzi
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
- Humanitas Clinical and Research Centre, IRCCS, Rozzano (Milan), Italy
| | - Qiuling Dong
- Institute of Epidemiology, Helmholtz Zentrum München, Research Unit of Molecular Epidemiology, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Panayiotis Louca
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | - Alessia Visconti
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | - Colette Christiansen
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
- School of Mathematics and Statistics, The Open University, Milton Keynes, U.K
| | - Taylor Breuninger
- Epidemiology, University Hospital Augsburg, University of Augsburg, Augsburg, Germany
| | - Jakob Linseisen
- Epidemiology, University Hospital Augsburg, University of Augsburg, Augsburg, Germany
- ZIEL-Institute for Food & Health, Technische Universität München, Freising, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Medical Faculty, Ludwig-Maximilian University Munich, Munich, Germany
| | - Harald Grallert
- Institute of Epidemiology, Helmholtz Zentrum München, Research Unit of Molecular Epidemiology, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Nina Wawro
- Epidemiology, University Hospital Augsburg, University of Augsburg, Augsburg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Francesco Asnicar
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | | | - Andrei-Florin Baleanu
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | | | - Nicola Segata
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Mario Falchi
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | - Annette Peters
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Munich Heart Alliance, German Center for Cardiovascular Research (DZHK e.V., Partner-Site Munich), Munich, Germany
| | - Paul W. Franks
- Lund University Diabetes Center, Lund University, Malmö, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Tim D. Spector
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | - Jordana T. Bell
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
| | - Christian Gieger
- Institute of Epidemiology, Helmholtz Zentrum München, Research Unit of Molecular Epidemiology, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Ana M. Valdes
- Academic Rheumatology Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, U.K
| | - Cristina Menni
- Department of Twin Research, King’s College London, St Thomas’ Hospital Campus, London, U.K
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