Improvement of Insulin Sensitivity after Lean Donor Feces in Metabolic Syndrome Is Driven by Baseline Intestinal Microbiota Composition

Abstract

The intestinal microbiota has been implicated in insulin resistance, although evidence regarding causality in humans is scarce. We therefore studied the effect of lean donor (allogenic) versus own (autologous) fecal microbiota transplantation (FMT) to male recipients with the metabolic syndrome. Whereas we did not observe metabolic changes at 18 weeks after FMT, insulin sensitivity at 6 weeks after allogenic FMT was significantly improved, accompanied by altered microbiota composition. We also observed changes in plasma metabolites such as γ-aminobutyric acid and show that metabolic response upon allogenic FMT (defined as improved insulin sensitivity 6 weeks after FMT) is dependent on decreased fecal microbial diversity at baseline. In conclusion, the beneficial effects of lean donor FMT on glucose metabolism are associated with changes in intestinal microbiota and plasma metabolites and can be predicted based on baseline fecal microbiota composition.

The use of faecal microbiota transplant as treatment for recurrent or refractoryClostridium difficileinfection and other potential indications: joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines

“…No improvement in insulin sensitivity was identified in patients transplanted with autologous FMT (ie, patients transplanted with their own collected faeces). The improvement in peripheral insulin sensitivity in the lean donor FMT group was accompanied by a small but significant improvement in HbA1c at 6 weeks,144 but no improvements in other metabolic parameters, such as weight. While these data are of interest, the working group felt that the limited, transient nature of the benefits seen and small size of the studies meant that FMT could not be recommended as treatment for metabolic syndrome.…”

Major microbiota dysbiosis in severe obesity: fate after bariatric surgery

“…After BS, enterotype modification was observed, but most patients remain with very low MGR, despite digestive tract modifications and clinical major improvements. Interventions, such as faecal transfer experiment, showed increased MGR and metabolic improvements in individuals with metabolic syndrome with low MGR at baseline 61. Thus, a perspective of this work would be to use strategies aiming at restoring gut microbiota ecosystem before or during the BS intervention and examine whether these interventions could further improve further MGR and/or clinical outcomes post-BS.…”

Emerging Role of the Gut Microbiome in Nonalcoholic Fatty Liver Disease: From Composition to Function

“…81, 82 FMT from lean to obese donors was shown to improve insulin sensitivity, albeit with only short-term improvement. 63, 80 Given NAFLD is commonly associated with insulin resistance, these results suggest that FMT could be efficacious in the management of NAFLD, however, improvement may be short-lived and limit the feasibility of this approach.…”