Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Via Ferdinando Baldelli 38, 00146, Rome, Italy.
Acta Diabetol. 2021 Aug;58(8):1009-1022. doi: 10.1007/s00592-020-01669-4. Epub 2021 Mar 22.
To identify fecal microbiota profiles associated with metabolic abnormalities belonging to the metabolic syndrome (MS), high count of white blood cells (WBCs) and insulin resistance (IR).
Sixty-eight young patients with obesity were stratified for percentile distribution of MS abnormalities. A MS risk score was defined as low, medium, and high MS risk. High WBCs were defined as a count ≥ 7.0 10/µL; severe obesity as body mass index Z-score ≥ 2 standard deviations; IR as homeostatic assessment model algorithm of IR (HOMA) ≥ 3.7. Stool samples were analyzed by 16S rRNA-based metagenomics.
We found reduced bacterial richness of fecal microbiota in patients with IR and high diastolic blood pressure (BP). Distinct microbial markers were associated to high BP (Clostridium and Clostridiaceae), low high-density lipoprotein cholesterol (Lachnospiraceae, Gemellaceae, Turicibacter), and high MS risk (Coriobacteriaceae), WBCs (Bacteroides caccae, Gemellaceae), severe obesity (Lachnospiraceae), and impaired glucose tolerance (Bacteroides ovatus and Enterobacteriaceae). Conversely, taxa such as Faecalibacterium prausnitzii, Parabacterodes, Bacteroides caccae, Oscillospira, Parabacterodes distasonis, Coprococcus, and Haemophilus parainfluenzae were associated to low MS risk score, triglycerides, fasting glucose and HOMA-IR, respectively. Supervised multilevel analysis grouped clearly "variable" patients based on the MS risk.
This was a proof-of-concept study opening the way at the identification of fecal microbiota signatures, precisely associated with cardiometabolic risk factors in young patients with obesity. These evidences led us to infer, while some gut bacteria have a detrimental role in exacerbating metabolic risk factors some others are beneficial ameliorating cardiovascular host health.
鉴定与代谢综合征（MS）、白细胞计数（WBC）升高和胰岛素抵抗（IR）相关的代谢异常相关的粪便微生物群特征。
将 68 名肥胖年轻患者按 MS 异常的百分位分布分层。将 MS 风险评分定义为低、中、高 MS 风险。高 WBC 定义为计数≥7.0×10/µL；严重肥胖定义为体重指数 Z 分数≥2 个标准差；IR 定义为稳态评估模型算法的 IR（HOMA）≥3.7。通过 16S rRNA 宏基因组学分析粪便样本。
我们发现 IR 和舒张压（BP）升高的患者粪便微生物群的细菌丰富度降低。独特的微生物标志物与高 BP（Clostridium 和 Clostridiaceae）、低高密度脂蛋白胆固醇（Lachnospiraceae、Gemellaceae、Turicibacter）和高 MS 风险（Coriobacteriaceae）、WBC（Bacteroides caccae、Gemellaceae）、严重肥胖（Lachnospiraceae）和糖耐量受损（Bacteroides ovatus 和 Enterobacteriaceae）相关。相反，Faecalibacterium prausnitzii、Parabacterodes、Bacteroides caccae、Oscillospira、Parabacterodes distasonis、Coprococcus 和 Haemophilus parainfluenzae 等分类群分别与低 MS 风险评分、甘油三酯、空腹血糖和 HOMA-IR 相关。基于 MS 风险的分级多水平分析清楚地将“变量”患者分组。
这是一项概念验证研究，为鉴定与肥胖年轻患者的心血管代谢危险因素精确相关的粪便微生物群特征开辟了道路。这些证据使我们推断，虽然一些肠道细菌在加剧代谢危险因素方面具有有害作用，但其他一些细菌则有益地改善了宿主的心血管健康。
