Pedersen Camilla, Gallagher Edith, Horton Felicity, Ellis Richard J, Ijaz Umer Z, Wu Huihai, Jaiyeola Etana, Diribe Onyinye, Duparc Thibaut, Cani Patrice D, Gibson Glenn R, Hinton Paul, Wright John, La Ragione Roberto, Robertson M Denise
1Faculty of Health and Medical Sciences,University of Surrey,Guildford GU2 7XH,UK.
2Medical Physics - Nuclear Medicine,Royal Surrey County Hospital, Guildford GU2 7XX,UK.
Br J Nutr. 2016 Dec;116(11):1869-1877. doi: 10.1017/S0007114516004086. Epub 2016 Dec 15.
Aberrant microbiota composition and function have been linked to several pathologies, including type 2 diabetes. In animal models, prebiotics induce favourable changes in the intestinal microbiota, intestinal permeability (IP) and endotoxaemia, which are linked to concurrent improvement in glucose tolerance. This is the first study to investigate the link between IP, glucose tolerance and intestinal bacteria in human type 2 diabetes. In all, twenty-nine men with well-controlled type 2 diabetes were randomised to a prebiotic (galacto-oligosaccharide mixture) or placebo (maltodextrin) supplement (5·5 g/d for 12 weeks). Intestinal microbial community structure, IP, endotoxaemia, inflammatory markers and glucose tolerance were assessed at baseline and post intervention. IP was estimated by the urinary recovery of oral 51Cr-EDTA and glucose tolerance by insulin-modified intravenous glucose tolerance test. Intestinal microbial community analysis was performed by high-throughput next-generation sequencing of 16S rRNA amplicons and quantitative PCR. Prebiotic fibre supplementation had no significant effects on clinical outcomes or bacterial abundances compared with placebo; however, changes in the bacterial family Veillonellaceae correlated inversely with changes in glucose response and IL-6 levels (r -0·90, P=0·042 for both) following prebiotic intake. The absence of significant changes to the microbial community structure at a prebiotic dosage/length of supplementation shown to be effective in healthy individuals is an important finding. We propose that concurrent metformin treatment and the high heterogeneity of human type 2 diabetes may have played a significant role. The current study does not provide evidence for the role of prebiotics in the treatment of type 2 diabetes.
异常的微生物群组成和功能与包括2型糖尿病在内的多种病理状况有关。在动物模型中,益生元可引起肠道微生物群、肠道通透性(IP)和内毒素血症的有利变化,这些变化与葡萄糖耐量的同时改善有关。这是第一项研究人类2型糖尿病中IP、葡萄糖耐量与肠道细菌之间联系的研究。总共29名2型糖尿病控制良好的男性被随机分为益生元(低聚半乳糖混合物)或安慰剂(麦芽糊精)补充剂组(5.5克/天,持续12周)。在基线和干预后评估肠道微生物群落结构、IP、内毒素血症、炎症标志物和葡萄糖耐量。IP通过口服51Cr-EDTA的尿回收率来估计,葡萄糖耐量通过胰岛素改良的静脉葡萄糖耐量试验来评估。通过对16S rRNA扩增子进行高通量下一代测序和定量PCR来进行肠道微生物群落分析。与安慰剂相比,益生元纤维补充剂对临床结果或细菌丰度没有显著影响;然而,在摄入益生元后,韦荣氏菌科细菌家族的变化与葡萄糖反应和IL-6水平的变化呈负相关(两者r均为-0.90,P = 0.042)。在健康个体中已证明有效的益生元剂量/补充时长下,微生物群落结构没有显著变化,这是一项重要发现。我们认为,同时进行的二甲双胍治疗和人类2型糖尿病的高度异质性可能起到了重要作用。目前的研究没有为益生元在2型糖尿病治疗中的作用提供证据。