Overall Structural Alteration of Gut Microbiota and Relationships with Risk Factors in Patients with Metabolic Syndrome Treated with Inulin Alone and with Other Agents: An Open-Label Pilot Study

Abstract

Objective. The relative contribution of some products with prebiotic effects, such as inulin, together with medications specific to the human gut microbiome has not been comprehensively studied. The present study determined the potential for manipulating populations in the gut microbiome using inulin alone and combined with other agents in individuals with metabolic syndrome (MetS). The study also assessed whether there is relationship variability in multiple clinical parameters in response to intervention with the changes in the gut milieu. Participants/Methods. This single-centre, single-blinded, randomised community-based pilot trial randomly assigned 60 patients (mean age, 46.3 y and male, 43%) with MetS to receive either inulin, inulin+traditional Chinese medicine (TCM), or inulin+metformin for 6 months. Lipid profiles, blood glucose, and uric acid (UA) levels were analysed in venous blood samples collected after overnight fast of 8 h at baseline and at the end of the follow-up period. Microbiota from stool samples were taxonomically analysed using 16S RNA amplicon sequencing, and an integrative analysis was conducted on microbiome and responsiveness data at 6 months. Results. The results of 16S rRNA sequencing showed that inulin resulted in a higher proportion of Bacteroides at the endpoint compared with inulin+TCM and inulin+metformin ( p = 0.024 ). More Romboutsia ( p = 0.043 ), Streptococcus ( p < 0.001 ), and Holdemanella ( p = 0.011 ) were found in inulin+TCM and inulin+metformin samples. We further identified gut microbiota relationships with lipids, UA, and glucose that impact the development of MetS. Conclusion. Among the groups, inulin alone or combined with metformin or TCM altered specific gut microbiota taxa but not the general diversity. Accordingly, we analysed metabolites associated with microbiota that might provide more information about intrinsic differences. Consequently, a reliable method could be developed for treating metabolic syndrome in the future.

Inulin from Dioscorea esculenta and Metformin in Combination Ameliorates Metabolic Syndrome in Rats by Altering Short-Chain Fatty Acids

“…27 A previous study showed that inulin improved glucose and lipid metabolism disorders in ob/ob mice through leptin pathway mediated by Prevotellaceae UCG 001. 28 Another previous study in diabetic rat model reported a suppression of proinflammatory cytokine production upon the administration of inulin attributed to reduced number of Mucispirillum and Ruminiclostridium_6. 24 Similarly, metformin has a suppressive response to proinflammatory cytokine.…”

Human gut microbiome: Therapeutic opportunities for metabolic syndrome—Hype or hope?

“…Inulin‐type fructan supplementation decreased fat mass slightly, but did not significantly change BMI, lipid or glucose homeostasis 106 . Inulin also favourably influenced microbiome composition 107,108 . While in adults no convincing effect on body weight could be observed, in obese children inulin and dietary fibre together with increased exercise showed a significant decrease in weight and body fat 109 .…”

“…106 Inulin also favourably influenced microbiome composition. 107,108 While in adults no convincing effect on body weight could be observed, in obese children inulin and dietary fibre together with increased exercise showed a significant decrease in weight and body fat. 109 Resistant starch type 4 (RS4) supplementation positively affected lipid metabolism, potentially by modulating bile acid metabolism and microbiome composition, but not glucose metabolism.…”

The Microbiota–Gut–Brain Axis in Metabolic Syndrome and Sleep Disorders: A Systematic Review

“…Overall, multiple studies agree that a reduction in butyrate producers, including Faecalibacterium, Alistipes, Oscillobacter, Roseburia, and Pseudofavonifractor, in MetS are key contributors to the pathogenic mechanisms of MetS [53]. Indeed, SCFAs, including butyrate, propionate, and acetate, have a particular affinity for G-protein coupled receptors, namely FFAR2 and FFAR3, which regulate satiety and intestinal motility by stimulating the secretion of glucagon-like peptide (GLP) and peptide YY (PYY) from intestinal L-cells [54].…”