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Akkermansia muciniphila is Negatively Correlated with Hemoglobin A1c in Refractory Diabetes. Microorganisms 2020; 8:microorganisms8091360. [PMID: 32899513 PMCID: PMC7565276 DOI: 10.3390/microorganisms8091360] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022] Open
Abstract
Patients with refractory diabetes are defined as type 2 diabetes (T2D) patients; they cannot achieve optimal glycemic control and exhibit persistent elevations of hemoglobin A1c (HbA1c) ≥8% while on appropriate therapy. Hyperglycemia can lead to severe microvascular/macrovascular complications. However, in contrast to T2D, few studies have focused specifically on the gut microbiota in refractory diabetes. To examine this issue, we recruited 79 subjects with T2D and refractory diabetes (RT2D), and all subjects received standard therapy with Metformin or other hypoglycemic agents with or without insulin for at least one year. The α-diversity displayed no significant difference, whereas the β-diversity showed a marginal significance (p = 0.054) between T2D and RT2D. The evaluation of taxonomic indices revealed reductions in both Akkermansia muciniphila and Fusobacterium and a corresponding enrichment of Bacteroides vulgatus, Veillonella denticariosi among those with RT2D. These microbial markers distinguished RT2D from T2D with an acceptable degree of discrimination (area under the curve (AUC) = 0.719, p < 0.01) and were involved in several glucose-related functional pathways. Furthermore, the relative abundance of Akkermansia muciniphila was negatively correlated with HbA1c. Our combined results reveal unique features of the gut microbiota in RT2D and suggest that the evaluation of the gut microbiota could provide insights into the mechanisms underlying glycemic control and the impact of therapeutic modalities in patients with RT2D.
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Martin C, Ait Boudaoud A, Poghosyan T, Zhu J, Larger E, Greenfield JR, Czernichow S, Rives-Lange C, Carette C. Prevalence of anti-GAD and IA2 autoantibodies in a French cohort of patients with diabetes eligible for bariatric surgery. DIABETES & METABOLISM 2019; 46:407-409. [PMID: 31874247 DOI: 10.1016/j.diabet.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 12/17/2022]
Affiliation(s)
- C Martin
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - A Ait Boudaoud
- Diabetes Department, Georges Pompidou European Hospital, AP-HP, Paris, France; Paris University, Paris, France
| | - T Poghosyan
- Digestive Surgery Department, Georges Pompidou European Hospital, AP-HP, Paris, France; Paris University, Paris, France
| | - J Zhu
- Biological Immunology Department, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - E Larger
- Paris University, Paris, France; Diabetes Department, Cochin Hospital, AP-HP, Paris, France
| | - J R Greenfield
- Department of Diabetes and Endocrinology, St. Vincent's Hospital, Sydney, NSW, Australia; Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, NSW, Australia; St Vincent's Clinic School, University of New South Wales, Sydney, NSW, Australia
| | - S Czernichow
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France; Diabetes Department, Georges Pompidou European Hospital, AP-HP, Paris, France; Paris University, Paris, France
| | - C Rives-Lange
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France; Paris University, Paris, France
| | - C Carette
- Nutrition Department, Georges Pompidou European Hospital, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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Carlsson ER, Grundtvig JLG, Madsbad S, Fenger M. Changes in Serum Sphingomyelin After Roux-en-Y Gastric Bypass Surgery Are Related to Diabetes Status. Front Endocrinol (Lausanne) 2018; 9:172. [PMID: 29922223 PMCID: PMC5996901 DOI: 10.3389/fendo.2018.00172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/03/2018] [Indexed: 12/19/2022] Open
Abstract
Metabolic surgery is superior to lifestyle intervention in reducing weight and lowering glycemia and recently suggested as treatment for type 2 diabetes mellitus. Especially Roux-en-Y gastric bypass (RYGB) has been focus for much research, but still the mechanisms of action are only partly elucidated. We suggest that several mechanisms might be mediated by sphingolipids like sphingomyelin. We measured serum sphingomyelin before and up to 2 years after RYGB surgery in 220 patients, divided before surgery in one non-diabetic subgroup and two diabetic subgroups, one of which contained patients obtaining remission of type 2 diabetes after RYGB, while patients in the other still had diabetes after RYGB. Pre- and postoperative sphingomyelin levels were compared within and between groups. Sphingomyelin levels were lower in diabetic patients than in non-diabetic patients before surgery. Following RYGB, mean sphingomyelin concentration fell significantly in the non-diabetic subgroup and the preoperative difference between patients with and without diabetes disappeared. Changes in diabetic subgroups were not significant. Relative to bodyweight, an increase in sphingomyelin was seen in all subgroups, irrespective of diabetes status. We conclude that RYGB has a strong influence on sphingomyelin metabolism, as seen reflected in changed serum levels. Most significantly, no differences between the two diabetic subgroups were detected after surgery, which might suggest that patients in both groups still are in a "diabetic state" using the non-diabetic subgroup as a reference.
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Affiliation(s)
- Elin Rebecka Carlsson
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Mogens Fenger
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Aleassa EM, Kroh M. Comment on: A β-cell pancreatic dysfunction participates in the hyperglycemic peaks observed after gastric bypass surgery of obese patients. Surg Obes Relat Dis 2016; 12:803-804. [PMID: 26947792 DOI: 10.1016/j.soard.2015.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 11/12/2015] [Accepted: 11/12/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Essa M Aleassa
- Cleveland Clinic Bariatric and Metabolic Institute Cleveland, Ohio
| | - Matthew Kroh
- Cleveland Clinic Bariatric and Metabolic Institute Cleveland, Ohio
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