1. Introduction
3. Discussion
Gut microbiota related to T2DM have been studied, but the results are inconsistent. In this study, we investigated the association between fecal bacterial composition, enterotypes, and T2DM in US adults, focusing on enterotypes. Our objective was to provide valuable insights into the role of gut microbiota in T2DM pathogenesis, specifically within different enterotypes, and to shed light on the link between gut microbiota and T2DM in the US population. Using a large dataset pooling fecal bacterial files of 1039 individuals with T2DM and 872 healthy adults from HMP data, we employed machine learning and network analysis to identify key bacteria and their interactions influencing T2DM incidence. Additionally, we conducted a metagenomic analysis to explore the functional implications of the microbial composition. Our findings revealed distinct enterotypes (Bacteroidaceae, Lachnospiraceae, and Prevotellaceae) associated with T2DM incidence, along with lower α-diversity in T2DM within specific enterotypes, indicating microbial diversity differences. The XGBoost model demonstrated high accuracy and sensitivity in predicting T2DM based on fecal bacterial composition. Furthermore, we observed specific bacterial taxa in the T2DM group compared to the healthy group, and metagenomic analysis unveiled associations between bacterial abundance and metabolic pathways relevant to T2DM. These novel findings enhance our understanding of the intricate interplay between gut microbiota and T2DM in the US population.
In summary, the fecal bacterial composition of US adults with T2DM was clearly separated from those of healthy participants. Regardless of enterotypes, Enterocloster bolteae, Facalicatena fissicatena, Clostridium symbiosum, and Facalibacterium prausnitizii were present in higher abundance, and Bacteroides koreensis, Oscillibacter ruminantium, Bacteroides uniformis, and Blautia wexlerae were present in lower numbers in the T2DM group compared to the healthy group in the XGBoost model. The gut microbiota in adults with T2DM in the USA was somewhat different from those in Asians with T2DM, which may be linked to different β-cell functions and mass in Asians and non-Asians. The interaction between the fecal bacteria was also different in different enterotypes. ET-L had a more stable gut microbiota population than ET-B, and adults with ET-P and ET-L had a lower T2DM incidence than those with ET-B. In the metagenomic analysis, gut bacteria composition in T2DM patients was inversely associated with energy utilization, butanoate and propanoate metabolism, and insulin signaling pathways compared to healthy adults. In conclusion, the gut bacteria related to T2DM mainly influence the energy metabolism and insulin signaling pathways in the US population, Caucasians, and the regulation of their network is linked to T2DM risk in different enterotypes. Therefore, the present study provides valuable insights into the link between gut microbiota and T2DM in US adults. This contributes to understanding T2DM etiology and highlights potential implications for personalized interventions or treatments.
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