PMID- 36992788
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230331
IS  - 2673-6616 (Electronic)
IS  - 2673-6616 (Linking)
VI  - 3
DP  - 2022
TI  - A Changed Gut Microbiota Diversity Is Associated With Metabolic Improvements 
      After Duodenal Mucosal Resurfacing With Glucagon-Like-Peptide-1 Receptor Agonist 
      in Type 2 Diabetes in a Pilot Study.
PG  - 856661
LID - 10.3389/fcdhc.2022.856661 [doi]
LID - 856661
AB  - INTRODUCTION: The gut microbiota influences and interacts with the host 
      metabolism through effects on nutrient metabolism and digestion. Duodenal Mucosal 
      Resurfacing (DMR) is a novel endoscopic procedure involving duodenal mucosal 
      ablation by the use of hydrothermal energy. DMR, when combined with a 
      glucagon-like peptide-1 receptor agonist (GLP-1RA), resulted in discontinuation 
      of exogenous insulin treatment in 69% of patients with insulin dependent type 2 
      diabetes mellitus (T2DM) in the INSPIRE study. These patients also experienced 
      improved glycaemic control and metabolic health. We thus investigated if these 
      clinical effects were associated with a change in gut microbiota alpha and beta 
      diversity. METHODS: Faecal samples from the 16 patients were obtained for 
      Illumina shotgun sequencing at baseline and 3 months after DMR. We assessed alpha 
      and beta diversity of the gut microbiota in these samples and analysed its 
      correlations with changes in HbA1c, body weight, and liver MRI proton density fat 
      fraction (PDFF). RESULTS: HbA1c correlated negatively with alpha diversity 
      (p=0.011, rho: -0.62) whereas changes in PDFF correlated significantly with beta 
      diversity (p=0.036, rho: 0.55) 3 months after initiation of the combined 
      intervention. These correlations with metabolic parameters were observed despite 
      finding no change in gut microbiota diversity at 3 months post DMR. DISCUSSION: 
      The correlation between gut microbiota richness (alpha diversity) and HbA1c as 
      well as the change in PDFF and changed microbiota composition (beta diversity) 
      suggests that changed gut microbiota diversity is associated with metabolic 
      improvements after DMR in combination with glucagon-like-peptide-1 receptor 
      agonist in type 2 diabetes. Larger controlled studies are however needed to find 
      causal links between DMR with GLP-1RA, the gut microbiota, and improvements in 
      metabolic health.
CI  - Copyright (c) 2022 Meiring, van Baar, Sorensen, Holleman, Soeters, Nieuwdorp and 
      Bergman.
FAU - Meiring, Suzanne
AU  - Meiring S
AD  - Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, 
      Netherlands.
FAU - van Baar, Annieke C G
AU  - van Baar ACG
AD  - Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, 
      Netherlands.
FAU - Sorensen, Nikolaj
AU  - Sorensen N
AD  - Scientific Operations Clinical Microbiomics, Copenhagen, Denmark.
FAU - Holleman, Frits
AU  - Holleman F
AD  - Internal Medicine, Amsterdam University Medical Centres, Amsterdam, Netherlands.
FAU - Soeters, Maarten R
AU  - Soeters MR
AD  - Endocrinology, Amsterdam University Medical Centres, Amsterdam, Netherlands.
FAU - Nieuwdorp, Max
AU  - Nieuwdorp M
AD  - Internal and Vascular Medicine, Amsterdam University Medical Centres, Amsterdam, 
      Netherlands.
FAU - Bergman, Jacques J G H M
AU  - Bergman JJGHM
AD  - Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, 
      Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20220705
PL  - Switzerland
TA  - Front Clin Diabetes Healthc
JT  - Frontiers in clinical diabetes and healthcare
JID - 9918266295306676
PMC - PMC10012157
OTO - NOTNLM
OT  - DMR
OT  - GLP-1RA
OT  - diabetes type 2
OT  - duodenal mucosal resurfacing
OT  - endoscopic
OT  - gut microbiota
OT  - microbiota diversity
COIS- MN is in the Scientific Advisory Board of Caelus Pharmaceuticals, the Netherlands 
      and Kaleido Biosciences, USA. However none of these are directly relevant to the 
      current paper. FH reports speaker fees from Sanofi, Bioton, Astra Zeneca, and 
      Boehringer Ingelheim. JB received research support from Fractyl Health Inc. for 
      IRB-based studies and received a consultancy fee for a single advisory board 
      meeting of Fractyl in September 2019. The remaining authors declare that the 
      research was conducted in the absence of any commercial or financial 
      relationships that could be construed as a potential conflict of interest.
EDAT- 2023/03/31 06:00
MHDA- 2023/03/31 06:01
PMCR- 2022/07/05
CRDT- 2023/03/30 02:45
PHST- 2022/01/17 00:00 [received]
PHST- 2022/03/11 00:00 [accepted]
PHST- 2023/03/31 06:01 [medline]
PHST- 2023/03/30 02:45 [entrez]
PHST- 2023/03/31 06:00 [pubmed]
PHST- 2022/07/05 00:00 [pmc-release]
AID - 10.3389/fcdhc.2022.856661 [doi]
PST - epublish
SO  - Front Clin Diabetes Healthc. 2022 Jul 5;3:856661. doi: 10.3389/fcdhc.2022.856661. 
      eCollection 2022.