期刊
GUT
卷 68, 期 2, 页码 263-270出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/gutjnl-2018-316155
关键词
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资金
- National Institutes of Health (NIH) grants from the National Heart, Lung, and Blood Institute [HL071981, HL034594, HL126024]
- National Institute of Diabetes and Digestive and Kidney Diseases [DK115679, DK091718, DK100383, DK078616]
- Boston Obesity Nutrition Research Center [DK46200]
- USA-Israel Binational Science Foundation [2011036]
- American Heart Association Scientist Development Award [0730094N]
- Japan Society for the Promotion of Science
Objective Alterations in gut microbiota have been linked to host insulin resistance, diabetes and impaired amino acid metabolism. We investigated whether changes in gut microbiota-dependent metabolite of trimethylamine N-oxide (TMAO) and its nutrient precursors (choline and L-carnitine) were associated with improvements in glucose metabolism and diabetes-related amino acids in a weight-loss diet intervention. Design We included 504 overweight and obese adults who were randomly assigned to one of four energy-reduced diets varying in macronutrient intake. The 6-month changes (.) in TMAO, choline and L-carnitine levels after the intervention were calculated. Results Greater decreases in choline and L-carnitine were significantly (p<0.05) associated with greater improvements in fasting insulin concentrations and homeostasis model assessment of insulin resistance (HOMA-IR) at 6 months. The reduction of choline was significantly related to 2-year improvements in glucose and insulin resistance. We found significant linkages between dietary fat intake and Delta TMAO for changes in fasting glucose, insulin and HOMA-IR (p(interaction) <0.05); a greater increase in TMAO was related to lesser improvements in the outcomes among participants who consumed a high-fat diet. In addition, Delta L-carnitine and Delta choline were significantly related to changes in amino acids (including branched-chain and aromatic amino acids). Interestingly, the associations of Delta TMAO, Delta choline and Delta L-carnitine with diabetes-related traits were independent of the changes in amino acids. Conclusion Our findings underscore the importance of changes in TMAO, choline and L-carnitine in improving insulin sensitivity during a weight-loss intervention for obese patients. Dietary fat intake may modify the associations of TMAO with insulin sensitivity and glucose metabolism.
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