Abstract
Objective
To compare the gut microbiome composition and serum metabolome profile among individuals
with spinal cord injury (SCI) and normal glucose tolerance (NGT) or prediabetes/type
2 diabetes (preDM/T2D).
Design
Cross-sectional design.
Setting
Research university.
Participants
A total of 25 adults (N=25) with SCI were included in the analysis and categorized
as NGT (n=16) or preDM/T2D (n=9) based on their glucose concentration at minute 120
during a 75-g oral glucose tolerance test. The American Diabetes Association diagnosis
guideline was used for grouping participants.
Interventions
Not applicable.
Main Outcome Measures
A stool sample was collected and used to assess the gut microbiome composition (alpha
and beta diversity, microbial abundance) via the 16s ribosomal RNA sequencing technique.
A fasting serum sample was used for liquid chromatography–mass spectrometry–based
untargeted metabolomics analysis, the results from which reflect the relative quantity
of metabolites detected and identified. Gut microbiome and metabolomics data were
analyzed by the Quantitative Insights into Microbial Ecology 2 and Metaboanalyst platforms,
respectively.
Results
Gut microbiome alpha diversity (Pielou's evenness index, Shannon's index) and beta
diversity (weighted UniFrac distances) differed between groups. Compared with participants
with NGT, participants with preDM/T2D had less evenness in microbial communities.
In particular, those with preDM/T2D had a lower abundance of the Clostridiales order
and higher abundance of the Akkermansia genus, as well as higher serum levels of gut-derived metabolites, including indoxyl sulfate
and phenylacetylglutamine (P < .05 for all).
Conclusions
Our results provide evidence for altered gut microbiome composition and dysregulation
of gut-derived metabolites in participants with SCI and preDM/T2D. Both indoxyl sulfate
and phenylacetylglutamine have been implicated in the development of cardiovascular
diseases in the able-bodied population. These findings may inform future investigations
in the field of SCI and cardiometabolic health.
List of abbreviations:
ASVs (amplicon sequence variant), GI (gastrointestinal), IL (interleukin), IS (indoxyl sulfate), NGT (normal glucose tolerance), OGTT (oral glucose tolerance test), preDM/T2D (prediabetes/type 2 diabetes), QIIME 2 (Quantitative Insights Into Microbial Ecology 2), SCI (spinal cord injury), TNF-α (tumor necrosis factor α), UAB (University of Alabama at Birmingham)Keywords
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Article info
Publication history
Published online: June 11, 2021
Accepted:
March 28,
2021
Received in revised form:
March 16,
2021
Received:
December 31,
2020
Footnotes
Supported by the National Institute of Health (NIH) /National Institute of Nursing (grant no. NINR-1R01NR016443), NIH/National Institute of Child Health and Human Development (grant no. NICHD-1K01HD087463), the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR The University of Alabama at Birmingham Spinal Cord Injury Model Systems, grant no. NIDILRR-90SI5019), and NIDILRR-Department of Health and Human Services-Administration for Community Living Sponsor award (grant no. NIDILRR-90SFGE0018).
Disclosure: none
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
