Gut bacteria Akkermansia has been shown an anti-obesity protective effect in previous studies and may be used as promising probiotics. However, the above effect may be confounded by common factors, such as sex, age and diets, which should be verified in a generalized population. We used datasets from the American Gut Project to strictly reassess the association and further examined the effect of aging on it. A total of 10,534 participants aged 20 to 99 years from the United States and the United Kingdom were included. The relative abundance of Akkermansia was assessed based on 16S rRNA sequencing data. Obesity (body mass index, BMI ≥ 30 kg/m2) risks were compared across Akkermansia quintiles in logistic models with adjustment for common confounders. Restricted cubic splines were used to examine dose response effects between Akkermansia, obesity and age. A sliding-windows-based algorithm was used to investigate the effect of aging on Akkermansia-obesity associations. The median abundance of Akkermansia was 0.08% (interquartile range: 0.006–0.93%), and the prevalence of obesity was 11.03%. Nonlinear association was detected between Akkermansia and obesity risk (P = 0.01). The odds ratios (95% confidence interval) for obesity across the increasing Akkermansia quintiles (referencing to the first quintile) were 1.14 (0.94–1.39), 0.94 (0.77–1.15), 0.70 (0.56–0.85) and 0.79 (0.64–0.96) after adjusting for age and sex (P for trend < 0.001). This association remained unchanged after further controlling for smoking, alcohol drinking, diet, and country. The odds ratios (95% CI) of Akkermansia were 0.19 (0.03–0.62) and 0.77 (0.64–0.91) before and over 40 years, respectively, indicating that the protective effect of Akkermansia against obesity was not stable with aging. High relative abundance of Akkermansia is associated with low risk of obesity and the association declines with aging.

中文翻译：

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肠道细菌 Akkermansia 与肥胖风险降低有关：来自美国肠道计划的证据

肠道细菌 Akkermansia 在之前的研究中已显示出抗肥胖保护作用，可用作有前途的益生菌。然而，上述效果可能会受到性别、年龄和饮食等常见因素的混淆，这应在一般人群中进行验证。我们使用美国肠道项目的数据集来严格重新评估这种关联，并进一步检查衰老对其的影响。共有来自美国和英国的 20 至 99 岁的 10,534 名参与者被纳入研究。基于 16S rRNA 测序数据评估 Akkermansia 的相对丰度。在逻辑模型中比较了 Akkermansia 五分位数的肥胖（体重指数，BMI ≥ 30 kg/m2）风险，并对常见的混杂因素进行了调整。限制三次样条用于检查 Akkermansia 之间的剂量反应效应，肥胖和年龄。使用基于滑动窗口的算法来研究衰老对 Akkermansia-肥胖关联的影响。Akkermansia 的中位丰度为 0.08%（四分位距：0.006-0.93%），肥胖患病率为 11.03%。在 Akkermansia 和肥胖风险之间检测到非线性关联 (P = 0.01)。在不断增加的阿克曼氏菌五分位数（参考第一个五分位数）中，肥胖的优势比（95% 置信区间）分别为 1.14（0.94-1.39）、0.94（0.77-1.15）、0.70（0.56-0.85）和 0.79（0.64-0.96） ) 调整年龄和性别后（趋势 P < 0.001）。在进一步控制吸烟、饮酒、饮食和国家后，这种关联保持不变。Akkermansia 的优势比 (95% CI) 在 40 年前和 40 年后分别为 0.19 (0.03–0.62) 和 0.77 (0.64–0.91)，表明 Akkermansia 对肥胖的保护作用随着年龄的增长而不稳定。Akkermansia 的高相对丰度与肥胖风险低有关，并且这种关联随着年龄的增长而下降。