TY - JOUR
T1 - Effect of Fecal Microbiota Transplantation Combined With Mediterranean Diet on Insulin Sensitivity in Subjects With Metabolic Syndrome
AU - Koopen, Annefleur M.
AU - Almeida, Eduardo L.
AU - Attaye, Ilias
AU - Witjes, Julia J.
AU - Rampanelli, Elena
AU - Majait, Soumia
AU - Kemper, Marleen
AU - Levels, Johannes H. M.
AU - Schimmel, Alinda W. M.
AU - Herrema, Hilde
AU - Scheithauer, Torsten P. M.
AU - Frei, Werner
AU - Dragsted, Lars
AU - Hartmann, Bolette
AU - Holst, Jens J.
AU - O’Toole, Paul W.
AU - Groen, Albert K.
AU - Nieuwdorp, Max
N1 - Funding Information: This study was supported by a JPI HDHL consortium grant (DINAMIC; Diet-Induced Arrangement of the Gut Microbiome for Improvement of Cardiometabolic Health 529051011). Publisher Copyright: © Copyright © 2021 Koopen, Almeida, Attaye, Witjes, Rampanelli, Majait, Kemper, Levels, Schimmel, Herrema, Scheithauer, Frei, Dragsted, Hartmann, Holst, O’Toole, Groen and Nieuwdorp. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6/10
Y1 - 2021/6/10
N2 - Background: Recent studies demonstrate that a Mediterranean diet has beneficial metabolic effects in metabolic syndrome subjects. Since we have shown that fecal microbiota transplantation (FMT) from lean donors exerts beneficial effects on insulin sensitivity, in the present trial, we investigated the potential synergistic effects on insulin sensitivity of combining a Mediterranean diet with donor FMT in subjects with metabolic syndrome. Design: Twenty-four male subjects with metabolic syndrome were put on a Mediterranean diet and after a 2-week run-in phase, the subjects were randomized to either lean donor (n = 12) or autologous (n = 12) FMT. Changes in the gut microbiota composition and bacterial strain engraftment after the 2-week dietary regimens and 6 weeks post-FMT were the primary endpoints. The secondary objectives were changes in glucose fluxes (both hepatic and peripheral insulin sensitivity), postprandial plasma incretin (GLP-1) levels, subcutaneous adipose tissue inflammation, and plasma metabolites. Results: Consumption of the Mediterranean diet resulted in a reduction in body weight, HOMA-IR, and lipid levels. However, no large synergistic effects of combining the diet with lean donor FMT were seen on the gut microbiota diversity after 6 weeks. Although we did observe changes in specific bacterial species and plasma metabolites, no significant beneficial effects on glucose fluxes, postprandial incretins, or subcutaneous adipose tissue inflammation were detected. Conclusions: In this small pilot randomized controlled trial, no synergistic beneficial metabolic effects of combining a Mediterranean diet with lean donor FMT on glucose metabolism were achieved. However, we observed engraftment of specific bacterial species. Future trials are warranted to test the combination of other microbial interventions and diets in metabolic syndrome.
AB - Background: Recent studies demonstrate that a Mediterranean diet has beneficial metabolic effects in metabolic syndrome subjects. Since we have shown that fecal microbiota transplantation (FMT) from lean donors exerts beneficial effects on insulin sensitivity, in the present trial, we investigated the potential synergistic effects on insulin sensitivity of combining a Mediterranean diet with donor FMT in subjects with metabolic syndrome. Design: Twenty-four male subjects with metabolic syndrome were put on a Mediterranean diet and after a 2-week run-in phase, the subjects were randomized to either lean donor (n = 12) or autologous (n = 12) FMT. Changes in the gut microbiota composition and bacterial strain engraftment after the 2-week dietary regimens and 6 weeks post-FMT were the primary endpoints. The secondary objectives were changes in glucose fluxes (both hepatic and peripheral insulin sensitivity), postprandial plasma incretin (GLP-1) levels, subcutaneous adipose tissue inflammation, and plasma metabolites. Results: Consumption of the Mediterranean diet resulted in a reduction in body weight, HOMA-IR, and lipid levels. However, no large synergistic effects of combining the diet with lean donor FMT were seen on the gut microbiota diversity after 6 weeks. Although we did observe changes in specific bacterial species and plasma metabolites, no significant beneficial effects on glucose fluxes, postprandial incretins, or subcutaneous adipose tissue inflammation were detected. Conclusions: In this small pilot randomized controlled trial, no synergistic beneficial metabolic effects of combining a Mediterranean diet with lean donor FMT on glucose metabolism were achieved. However, we observed engraftment of specific bacterial species. Future trials are warranted to test the combination of other microbial interventions and diets in metabolic syndrome.
KW - fecal microbiota transplantation
KW - gut microbiota
KW - insulin sensitivity
KW - mediterranean diet
KW - metabolic syndrome
UR - http://www.scopus.com/inward/record.url?scp=85108595003&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fmicb.2021.662159
DO - https://doi.org/10.3389/fmicb.2021.662159
M3 - Article
C2 - 34177842
SN - 1664-302X
VL - 12
JO - Frontiers in Microbiology
JF - Frontiers in Microbiology
M1 - 662159
ER -