Differential effects of inulin and fructooligosaccharides on gut microbiota composition and glycemic metabolism in overweight/obese and healthy individuals: a randomized, double-blind clinical trial.
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引用次数: 0
Abstract
Background: Modulating the gut microbiota with prebiotics is a promising strategy for managing metabolic diseases. However, the clinical effects on glycemic metabolism across different populations remain uncertain. In this study, we conducted a randomized, double-blind investigation to examine the impact of inulin and fructooligosaccharides (FOS) on glycemic metabolism in overweight/obese and healthy adults.
Methods: A total of 131 adults were included, with 44 receiving inulin, 43 receiving FOS, and 44 receiving placebo over a period of 4 weeks. Blood and fecal samples were collected before and after the intervention, and various metabolic parameters, gut microbiota composition, and metabolites were analyzed.
Results: Placebo had no effect on glycemic metabolism or gut microbiota. Inulin significantly reduced glucose levels at 1 h (Cohen's d = 0.71, p = 0.041) and 2 h (Cohen's d = 0.73, p = 0.028) during oral glucose tolerance test (OGTT), increased fasting insulin (Cohen's d = 0.70, p = 0.008), and lowered homocysteine (HCY) levels (Cohen's d = 0.76, p = 0.014) in overweight/obese individuals. These effects were not observed in healthy individuals. In contrast, although FOS significantly decreased HCY (Cohen's d = 0.72, p = 0.023), it did not improve glycemic metrics in either group. Inulin also reduced the abundance of Ruminococcus by 72.0% (from 1.661% ± 1.501% to 0.465% ± 0.594%), positively correlating with improved glycemic outcomes. Propionate levels decreased significantly in both overweight/obese (Cohen's d = 0.89, p = 0.014) and healthy participants (Cohen's d = 1.19, p = 0.020) following inulin. Functional prediction of gut microbiota revealed upregulation of microbial folate and glutathione metabolism with inulin, and purine metabolism with FOS.
Conclusions: Practically, inulin may be more suitable for managing glycemic dysregulation in overweight or obese individuals, while FOS may be considered for HCY reduction in individuals with normal glycemic status. Such targeted use of prebiotics could complement existing dietary and pharmacologic strategies in personalized metabolic care.
背景：利用益生元调节肠道微生物群是治疗代谢性疾病的一种很有前途的策略。然而，不同人群对血糖代谢的临床影响仍不确定。在这项研究中，我们进行了一项随机、双盲研究，研究了菊粉和低聚果糖（FOS）对超重/肥胖和健康成年人血糖代谢的影响。方法：共纳入131名成年人，其中44人接受菊粉治疗，43人接受FOS治疗，44人接受安慰剂治疗，为期4周。在干预前后采集血液和粪便样本，分析各种代谢参数、肠道菌群组成和代谢物。结果：安慰剂对血糖代谢和肠道菌群没有影响。在口服糖耐量试验（OGTT）中，菊粉显著降低了1 h （Cohen’s d = 0.71, p = 0.041）和2 h （Cohen’s d = 0.73, p = 0.028）的血糖水平，增加了超重/肥胖个体的空腹胰岛素水平（Cohen’s d = 0.70, p = 0.008），降低了同型半胱氨酸（HCY）水平（Cohen’s d = 0.76, p = 0.014）。在健康个体中没有观察到这些影响。相比之下，尽管FOS显著降低了HCY (Cohen’s d = 0.72, p = 0.023)，但没有改善两组的血糖指标。菊粉还使瘤胃球菌的丰度降低了72.0%（从1.661%±1.501%降低到0.465%±0.594%），与改善血糖结果呈正相关。在服用菊粉后，超重/肥胖参与者（Cohen’s d = 0.89, p = 0.014）和健康参与者（Cohen’s d = 1.19, p = 0.020）的丙酸水平均显著下降。肠道微生物群的功能预测显示，菊粉上调了微生物叶酸和谷胱甘肽代谢，FOS上调了微生物嘌呤代谢。结论：实际上，菊粉可能更适合于治疗超重或肥胖个体的血糖失调，而FOS可能被考虑用于血糖状态正常的个体的HCY降低。这种有针对性地使用益生元可以补充现有的个性化代谢护理的饮食和药物策略。试验注册号：ChiCTR-IOR-17010574。
期刊介绍：
BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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