Gut Microbial Signatures for Glycemic Responses of GLP-1 Receptor Agonists in Type 2 Diabetic Patients: A Pilot Study

Chih Yiu Tsai, Hsiu Chen Lu, Yu Hsien Chou, Po Yu Liu, Hsin Yun Chen, Meng Chuan Huang, Chia Hung Lin*, Chi Neu Tsai*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

58 Scopus citations

Abstract

Backgrounds: Glucagon-like peptide-1 receptor agonist (GLP-1 RA) is probably one of more effective antidiabetic agents in treatment of type 2 diabetes mellitus (T2D). However, the heterogenicity in responses to GLP-1 RA may be potentially related to gut microbiota, although no human evidence has been published. This pilot study aims to identify microbial signatures associated with glycemic responses to GLP-1 RA. Materials and Methods: Microbial compositions of 52 patients with T2D receiving GLP-1 RA were determined by 16S rRNA amplicon sequencing. Bacterial biodiversity was compared between responders versus non-responders. Pearson’s correlation and random forest tree algorithm were used to identify microbial features of glycemic responses in T2D patients and multivariable linear regression models were used to validate clinical relevance. Results: Beta diversity significantly differed between GLP-1 RA responders (n = 34) and non-responders (n = 18) (ADONIS, P = 0.004). The top 17 features associated with glycohemoglobin reduction had a 0.96 diagnostic ability, based on area under the ROC curve: Bacteroides dorei and Roseburia inulinivorans, the two microbes having immunomodulation effects, along with Lachnoclostridium sp. and Butyricicoccus sp., were positively correlated with glycemic reduction; Prevotella copri, the microbe related to insulin resistance, together with Ruminococcaceae sp., Bacteroidales sp., Eubacterium coprostanoligenes sp., Dialister succinatiphilus, Alistipes obesi, Mitsuokella spp., Butyricimonas virosa, Moryella sp., and Lactobacillus mucosae had negative correlation. Furthermore, Bacteroides dorei, Lachnoclostridium sp. and Mitsuokella multacida were significant after adjusting for baseline glycohemoglobin and C-peptide concentrations, two clinical confounders. Conclusions: Unique gut microbial signatures are associated with glycemic responses to GLP-RA treatment and reflect degrees of dysbiosis in T2D patients.

Original languageEnglish
Article number814770
JournalFrontiers in Endocrinology
Volume12
DOIs
StatePublished - 10 01 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Tsai, Lu, Chou, Liu, Chen, Huang, Lin and Tsai.

Keywords

  • GLP-1 receptor agonists
  • GLP-1 resistance
  • dysbiosis
  • glycemic response
  • gut microbiota
  • type 2 diabetes mellitus

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