SGLT-2 Inhibitors and Metabolic Outcomes: A Primary Data Study Exploring the Microbiota-Diabetes Connection.

IF 3.4 3区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Metabolites Pub Date : 2025-06-18 DOI:10.3390/metabo15060411
Nicoleta Mihaela Mindrescu, Cristian Guja, Viorel Jinga, Sorina Ispas, Antoanela Curici, Rucsandra Elena Danciulescu Miulescu, Andreea Nelson Twakor, Anca Mihaela Pantea Stoian
{"title":"SGLT-2 Inhibitors and Metabolic Outcomes: A Primary Data Study Exploring the Microbiota-Diabetes Connection.","authors":"Nicoleta Mihaela Mindrescu, Cristian Guja, Viorel Jinga, Sorina Ispas, Antoanela Curici, Rucsandra Elena Danciulescu Miulescu, Andreea Nelson Twakor, Anca Mihaela Pantea Stoian","doi":"10.3390/metabo15060411","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The gut microbiota plays a critical role in metabolic health and type 2 diabetes mellitus (T2DM). Alterations in microbial composition may influence glycemic control and systemic inflammation.</p><p><strong>Materials and methods: </strong>In this single-center, randomized study, 60 adults with T2DM receiving metformin were evaluated biologically and received either empagliflozin or sitagliptin. Demographic, metabolic, and lifestyle data were collected. Gut microbiota profiling was conducted at two timepoints to assess changes in bacterial and fungal taxa. Blood glucose, HbA1c, and inflammation markers were analyzed longitudinally.</p><p><strong>Results: </strong>Both treatment groups showed significant improvements in glycemic control. Median fasting glucose decreased from 132 to 123 mg/dL (<i>p</i> = 0.046) in the sitagliptin group and from 131 to 114 mg/dL (<i>p</i> = 0.025) in the empagliflozin group. Median HbA1c levels declined significantly in both groups, with a greater reduction in the empagliflozin group (<i>p</i> = 0.001 vs. <i>p</i> = 0.049). The microbiota analysis revealed an increase in beneficial bacteria (e.g., <i>Bifidobacterium</i> spp. and <i>Lactobacillus</i> spp.) and a decrease in pro-inflammatory taxa <i>(Escherichia coli</i> and <i>Streptococcus</i> spp.). Notably, empagliflozin was associated with a more pronounced microbiota rebalancing and a significant decline in fungal overgrowth (e.g., <i>Candida</i> spp.; <i>p</i> = 0.034).</p><p><strong>Conclusions: </strong>Treatment with sitagliptin and empagliflozin led to improved glycemic outcomes and partial restoration of gut microbial balance in T2DM patients. Empagliflozin showed superior efficacy in modulating both glycemia and dysbiosis.</p>","PeriodicalId":18496,"journal":{"name":"Metabolites","volume":"15 6","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12195300/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Metabolites","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.3390/metabo15060411","RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The gut microbiota plays a critical role in metabolic health and type 2 diabetes mellitus (T2DM). Alterations in microbial composition may influence glycemic control and systemic inflammation.

Materials and methods: In this single-center, randomized study, 60 adults with T2DM receiving metformin were evaluated biologically and received either empagliflozin or sitagliptin. Demographic, metabolic, and lifestyle data were collected. Gut microbiota profiling was conducted at two timepoints to assess changes in bacterial and fungal taxa. Blood glucose, HbA1c, and inflammation markers were analyzed longitudinally.

Results: Both treatment groups showed significant improvements in glycemic control. Median fasting glucose decreased from 132 to 123 mg/dL (p = 0.046) in the sitagliptin group and from 131 to 114 mg/dL (p = 0.025) in the empagliflozin group. Median HbA1c levels declined significantly in both groups, with a greater reduction in the empagliflozin group (p = 0.001 vs. p = 0.049). The microbiota analysis revealed an increase in beneficial bacteria (e.g., Bifidobacterium spp. and Lactobacillus spp.) and a decrease in pro-inflammatory taxa (Escherichia coli and Streptococcus spp.). Notably, empagliflozin was associated with a more pronounced microbiota rebalancing and a significant decline in fungal overgrowth (e.g., Candida spp.; p = 0.034).

Conclusions: Treatment with sitagliptin and empagliflozin led to improved glycemic outcomes and partial restoration of gut microbial balance in T2DM patients. Empagliflozin showed superior efficacy in modulating both glycemia and dysbiosis.

SGLT-2抑制剂和代谢结果:探索微生物与糖尿病关系的初步数据研究。
背景:肠道菌群在代谢健康和2型糖尿病(T2DM)中起着关键作用。微生物组成的改变可能影响血糖控制和全身性炎症。材料和方法:在这项单中心随机研究中,60名接受二甲双胍治疗的成年T2DM患者接受了恩格列净或西格列汀的生物学评估。收集了人口统计、代谢和生活方式数据。在两个时间点进行肠道微生物群分析,以评估细菌和真菌分类群的变化。纵向分析血糖、糖化血红蛋白和炎症指标。结果:两组患者血糖控制均有明显改善。西格列汀组中位空腹血糖从132降至123 mg/dL (p = 0.046),恩格列净组中位空腹血糖从131降至114 mg/dL (p = 0.025)。两组中位HbA1c水平均显著下降,恩格列净组降低幅度更大(p = 0.001 vs. p = 0.049)。微生物群分析显示,有益菌群(如双歧杆菌和乳杆菌)增加,促炎菌群(如大肠杆菌和链球菌)减少。值得注意的是,恩格列净与更明显的微生物群再平衡和真菌过度生长的显着下降有关(例如,念珠菌;P = 0.034)。结论:西格列汀和恩格列净治疗可改善T2DM患者的血糖结局并部分恢复肠道微生物平衡。恩格列净在调节血糖和生态失调方面均表现出优越的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Metabolites
Metabolites Biochemistry, Genetics and Molecular Biology-Molecular Biology
CiteScore
5.70
自引率
7.30%
发文量
1070
审稿时长
17.17 days
期刊介绍: Metabolites (ISSN 2218-1989) is an international, peer-reviewed open access journal of metabolism and metabolomics. Metabolites publishes original research articles and review articles in all molecular aspects of metabolism relevant to the fields of metabolomics, metabolic biochemistry, computational and systems biology, biotechnology and medicine, with a particular focus on the biological roles of metabolites and small molecule biomarkers. Metabolites encourages scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on article length. Sufficient experimental details must be provided to enable the results to be accurately reproduced. Electronic material representing additional figures, materials and methods explanation, or supporting results and evidence can be submitted with the main manuscript as supplementary material.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信