Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, Brussels, Belgium.
Laboratory of Diabetology, Nutrition and Metabolic disease, Liège, Université de Liège, Belgium.
Clin Nutr. 2020 Dec;39(12):3618-3628. doi: 10.1016/j.clnu.2020.04.005. Epub 2020 Apr 13.
The gut microbiota is altered in obesity and is strongly influenced by nutrients and xenobiotics. We have tested the impact of native inulin as prebiotic present in vegetables and added as a supplement on gut microbiota-related outcomes in obese patients. Metformin treatment was analyzed as a potential modulator of the response.
A randomized, single-blinded, multicentric, placebo-controlled trial was conducted in 150 obese patients who received 16 g/d native inulin versus maltodextrin, coupled to dietary advice to consume inulin-rich versus -poor vegetables for 3 months, respectively, in addition to dietary caloric restriction. Anthropometry, diagnostic imaging (abdominal CT-scan, fibroscan), food-behavior questionnaires, serum biology and fecal microbiome (primary outcome; 16S rDNA sequencing) were analyzed before and after the intervention.
Both placebo and prebiotic interventions lowered energy intake, BMI, systolic blood pressure, and serum γ-GT. The prebiotic induced greater weight loss and additionally decreased diastolic blood pressure, AST and insulinemia. Metformin treatment compromised most of the gut microbiota changes and metabolic improvements linked to prebiotic intervention. The prebiotic modulated specific bacteria, associated with the improvement of anthropometry (i.e. a decrease in Desulfovibrio and Clostridium sensu stricto). A large increase in Bifidobacterium appears as a signature of inulin intake rather than a driver of prebiotic-linked biological outcomes.
Inulin-enriched diet is able to promote weight loss in obese patients, the treatment efficiency being related to gut microbiota characteristics. This treatment is more efficacious in patients who did not receive metformin as anti-diabetic drugs prior the intervention, supporting that both drug treatment and microbiota might be taken into account in personalized nutrition interventions. Registered under ClinicalTrials.gov Identifier no NCT03852069.
肠道微生物群在肥胖中发生改变，并且强烈受到营养素和外源性化学物质的影响。我们已经测试了作为蔬菜中存在的天然菊粉的益生元对肥胖患者肠道微生物群相关结果的影响，该菊粉被添加为补充剂。二甲双胍治疗被分析为潜在的反应调节剂。
在 150 名肥胖患者中进行了一项随机、单盲、多中心、安慰剂对照试验，这些患者每天接受 16 克天然菊粉或麦芽糊精，同时接受饮食建议，分别食用富含和缺乏菊粉的蔬菜，为期 3 个月，同时进行饮食热量限制。在干预前后分析了人体测量学、诊断影像学（腹部 CT 扫描、纤维扫描）、饮食行为问卷、血清生物学和粪便微生物组（主要结局；16S rDNA 测序）。
安慰剂和益生元干预均降低了能量摄入、BMI、收缩压和血清γ-GT。益生元诱导了更大的体重减轻，并且还降低了舒张压、AST 和胰岛素血症。二甲双胍治疗损害了与益生元干预相关的大多数肠道微生物群变化和代谢改善。益生元调节了特定的细菌，与人体测量学的改善相关（即，脱硫弧菌和严格梭菌的减少）。双歧杆菌的大量增加似乎是菊粉摄入的特征，而不是益生元相关生物学结局的驱动因素。
富含菊粉的饮食能够促进肥胖患者的体重减轻，治疗效率与肠道微生物群特征有关。这种治疗在未接受二甲双胍作为抗糖尿病药物治疗的患者中更有效，这支持在个性化营养干预中同时考虑药物治疗和微生物群。在 ClinicalTrials.gov 标识符下注册为 NCT03852069。
