Vidarium, Nutrition, Health and Wellness Research Center, Grupo Empresarial Nutresa, Medellin, Colombia.
Dinámica IPS, Especialista en Ayudas Diagnósticas, Medellin, Colombia.
Int J Obes (Lond). 2018 Mar;42(3):424-432. doi: 10.1038/ijo.2017.281. Epub 2017 Nov 16.
The gut microbiota associates with obesity and related disorders, but recent meta-analyses have found that this association is, at best, of small effect. We argue that such analyses are flawed by the use of body mass index (BMI) as sole proxy for disease, and explore a classification method that distinguishes the cardiometabolic health status of individuals to look for more comprehensive associations between gut microbes and health.
We analyzed a 441 community-dwelling cohort on which we obtained demographic and health information, anthropometry and blood biochemistry data that served to categorize participants according to BMI, cardiometabolic health status and body size phenotypes. In addition, the participants donated fecal samples from which we performed 16S rRNA gene sequencing to analyze the gut microbiota.
We observed that health-related variables deteriorate with increased BMI, and that there are further discrepancies within a given BMI category when distinguishing cardiometabolically healthy and unhealthy individuals. Regarding the gut microbiota, both obesity and cardiovascular disease associate with reductions in α-diversity; having lean, healthy individuals the most diverse microbiotas. Moreover, the association between the gut microbiota and health stems from particular consortia of microbes; the prevalence of consortia involving pathobionts and Lachnospiraceae are increased in obese and cardiometabolically abnormal subjects, whereas consortia including Akkermansia muciniphila and Methanobrevibacter, Oscillospira and Dialister have higher prevalence in cardiometabolically healthy and normoweight participants.
The incorporation of cardiometabolic data allows a refined identification of dissimilarities in the gut microbiota; within a given BMI category, marker taxa associated with obesity and cardiometabolic disease are exacerbated in individuals with abnormal health status. Our results highlight the importance of the detailed assessment and classification of individuals that should be carried out prior to the evaluation of obesity treatments targeting the gut microbiota.
肠道微生物群与肥胖和相关疾病有关，但最近的荟萃分析发现，这种关联最多只有微小的影响。我们认为，这种分析存在缺陷，因为它仅使用体重指数 (BMI) 作为疾病的替代指标，并且我们正在探索一种分类方法，该方法可以区分个体的心脏代谢健康状况，以寻找肠道微生物群与健康之间更全面的关联。
我们分析了一个由 441 名居住在社区的队列组成的样本，我们获得了人口统计学和健康信息、人体测量学和血液生化数据，这些数据用于根据 BMI、心脏代谢健康状况和身体大小表型对参与者进行分类。此外，参与者捐赠了粪便样本，我们对其进行了 16S rRNA 基因测序，以分析肠道微生物群。
我们观察到，与 BMI 增加相关的健康相关变量会恶化，并且在区分心脏代谢健康和不健康个体时，在给定的 BMI 类别中还存在进一步的差异。关于肠道微生物群，肥胖和心血管疾病都与 α 多样性的降低有关；拥有瘦而健康的个体具有最多样的微生物群。此外，肠道微生物群与健康之间的关联源于特定的微生物群落；肥胖和心脏代谢异常患者中，与病原体和lachnospiraceae 相关的共生体以及包括 Akkermansia muciniphila 和 Methanobrevibacter、Oscillospira 和 Dialister 的共生体的患病率增加，而在心脏代谢健康和体重正常的参与者中，与 Akkermansia muciniphila 和 Methanobrevibacter、Oscillospira 和 Dialister 相关的共生体的患病率更高。
纳入心脏代谢数据可以更精细地识别肠道微生物群的差异；在给定的 BMI 类别中，与肥胖和心脏代谢疾病相关的标记分类群在健康状况异常的个体中更为严重。我们的研究结果强调了在评估针对肠道微生物群的肥胖治疗之前，对个体进行详细评估和分类的重要性。
