1型糖尿病合并超重或肥胖的年轻成年人的饮食摄入与肠道微生物群和短链脂肪酸的关联
Associations of Dietary Intake with the Intestinal Microbiota and Short-Chain Fatty Acids Among Young Adults with Type 1 Diabetes and Overweight or Obesity.
作者信息
Igudesman Daria, Crandell Jamie L, Corbin Karen D, Hooper Julie, Thomas Joan M, Bulik Cynthia M, Pence Brian W, Pratley Richard E, Kosorok Michael R, Maahs David M, Carroll Ian M, Mayer-Davis Elizabeth J
机构信息
Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; AdventHealth Translational Research Institute, Orlando, FL, USA.
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
J Nutr. 2023 Apr;153(4):1178-1188. doi: 10.1016/j.tjnut.2022.12.017. Epub 2022 Dec 27.
BACKGROUND
Diet, a key component of type 1 diabetes (T1D) management, modulates the intestinal microbiota and its metabolically active byproducts-including SCFA-through fermentation of dietary carbohydrates such as fiber. However, the diet-microbiome relationship remains largely unexplored in longstanding T1D.
OBJECTIVES
We evaluated whether increased carbohydrate intake, including fiber, is associated with increased SCFA-producing gut microbes, SCFA, and intestinal microbial diversity among young adults with longstanding T1D and overweight or obesity.
METHODS
Young adult men and women with T1D for ≥1 y, aged 19-30 y, and BMI of 27.0-39.9 kg/m at baseline provided stool samples at baseline and 3, 6, and 9 mo of a randomized dietary weight loss trial. Diet was assessed by 1-2 24-h recalls. The abundance of SCFA-producing microbes was measured using 16S rRNA gene sequencing. GC-MS measured fecal SCFA (acetate, butyrate, propionate, and total) concentrations. Adjusted and Bonferroni-corrected generalized estimating equations modeled associations of dietary fiber (total, soluble, and pectins) and carbohydrate (available carbohydrate, and fructose) with microbiome-related outcomes. Primary analyses were restricted to data collected before COVID-19 interruptions.
RESULTS
Fiber (total and soluble) and carbohydrates (available and fructose) were positively associated with total SCFA and acetate concentrations (n = 40 participants, 52 visits). Each 10 g/d of total and soluble fiber intake was associated with an additional 8.8 μmol/g (95% CI: 4.5, 12.8 μmol/g; P = 0.006) and 24.0 μmol/g (95% CI: 12.9, 35.1 μmol/g; P = 0.003) of fecal acetate, respectively. Available carbohydrate intake was positively associated with SCFA producers Roseburia and Ruminococcus gnavus. All diet variables except pectin were inversely associated with normalized abundance of Bacteroides and Alistipes. Fructose was inversely associated with Akkermansia abundance.
CONCLUSIONS
In young adults with longstanding T1D, fiber and carbohydrate intake were associated positively with fecal SCFA but had variable associations with SCFA-producing gut microbes. Controlled feeding studies should determine whether gut microbes and SCFA can be directly manipulated in T1D.
背景
饮食是1型糖尿病（T1D）管理的关键组成部分，通过对膳食纤维等膳食碳水化合物的发酵，调节肠道微生物群及其代谢活性副产物，包括短链脂肪酸（SCFA）。然而，在长期T1D中，饮食与微生物组的关系在很大程度上仍未得到探索。
目的
我们评估了增加碳水化合物摄入量（包括膳食纤维）是否与长期患有T1D且超重或肥胖的年轻人中产生SCFA的肠道微生物、SCFA和肠道微生物多样性增加有关。
方法
在一项随机饮食减肥试验的基线、3个月、6个月和9个月时，患有T1D≥1年、年龄在19 - 30岁、基线体重指数（BMI）为27.0 - 39.9 kg/m²的年轻成年男性和女性提供粪便样本。通过1 - 2次24小时饮食回顾评估饮食情况。使用16S rRNA基因测序测量产生SCFA的微生物的丰度。气相色谱 - 质谱法测量粪便中SCFA（乙酸盐、丁酸盐、丙酸盐和总量）的浓度。调整后的Bonferroni校正广义估计方程模拟膳食纤维（总量、可溶性和果胶）和碳水化合物（可利用碳水化合物和果糖）与微生物组相关结果之间的关联。主要分析仅限于在COVID - 19干扰之前收集的数据。
结果
纤维（总量和可溶性）以及碳水化合物（可利用的和果糖）与总SCFA和乙酸盐浓度呈正相关（n = 40名参与者，52次访视）。每天每增加10 g总量和可溶性纤维摄入量，分别与粪便乙酸盐增加8.8 μmol/g（95% CI：4.5，12.8 μmol/g；P = 0.006）和24.0 μmol/g（95% CI：12.9，35.1 μmol/g；P = 0.003）相关。可利用碳水化合物摄入量与产生SCFA的罗氏菌属和纤细瘤胃球菌呈正相关。除果胶外，所有饮食变量与拟杆菌属和阿利斯杆菌属的标准化丰度呈负相关。果糖与阿克曼氏菌属丰度呈负相关。
结论
在长期患有T1D的年轻人中，纤维和碳水化合物摄入量与粪便SCFA呈正相关，但与产生SCFA的肠道微生物的关联各不相同。对照喂养研究应确定在T1D中肠道微生物和SCFA是否可以直接调控。
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