Aims. Accumulating evidence indicates gut microbiota dysbiosis is involved in metabolic disorders, including prediabetes. The prebiotic inulin has been frequently reported to exert beneficial effects on the host metabolism. Here, we aimed to evaluate whether dietary supplementation with inulin modulates gut microbiota structure in prediabetes, affecting glucose and lipid metabolism. Methods. We performed a prospective single-arm study. A total of 49 subjects with prediabetes (WHO 1999 criteria) were voluntarily enrolled. Each subject received a daily supplement with 15 g of inulin for 6 months. Glucose and lipid metabolic parameters and gut microbiota were analyzed at baseline and at 3 and 6 months after inulin intervention. Intestinal microbiota profile was evaluated using the Illumina MiSeq platform based on V3-V4 bacterial 16S rRNA gene. Results. The mean age of 49 subjects was 56.6 ± 6.9 years and BMI was 25.07 ± 3.02 kg/m². After 24 weeks of prevention, inulin significantly decreased fasting insulin (2.38 ± 0.50 vs. 2.22 ± 0.62, ) and 2-hour post-OGTT insulin (4.01 ± 0.77 vs. 3.74 ± 0.76, ) and improved HOMA-IR (1.05 ± 0.53 vs. 0.85 ± 0.66, ). Gut microbiota analysis indicated that inulin supplement resulted in an increase in the relative abundance of Actinobacteria, Bifidobacteriales, Bifidobacteriaceae, Lactobacillaceae, Bifidobacterium, Lactobacillus, and Anaerostipes both at 3 and 6 months, while with a decrease in the relative abundance of Alistipes. Spearman correlation analysis revealed altered microbial community was associated with glucose and lipids metabolic parameters. Conclusions. Inulin supplementation improves insulin resistance of prediabetes and exerts beneficial effects on modulating the intestinal microbiota composition. These findings suggest that insulin may be a potentially novel and inexpensive intervention for prediabetes.

中文翻译：

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膳食补充剂菊粉可调节肠道微生物群并改善糖尿病前期的胰岛素敏感性

目标。越来越多的证据表明，肠道微生物群失调与代谢紊乱有关，包括糖尿病前期。益生元菊粉经常被报道对宿主代谢产生有益影响。在这里，我们旨在评估膳食补充剂菊粉是否会调节糖尿病前期的肠道微生物群结构，从而影响葡萄糖和脂质代谢。方法. 我们进行了一项前瞻性单臂研究。共有 49 名糖尿病前期受试者（WHO 1999 标准）自愿入组。每个受试者每天接受 15 克菊粉的补充，持续 6 个月。在基线以及菊粉干预后 3 个月和 6 个月时分析了葡萄糖和脂质代谢参数以及肠道微生物群。使用基于 V3-V4 细菌 16S rRNA 基因的 Illumina MiSeq 平台评估肠道微生物群谱。结果。49 名受试者的平均年龄为 56.6 ± 6.9 岁，BMI 为 25.07 ± 3.02 kg/m ²。预防 24 周后，菊粉显着降低空腹胰岛素（2.38 ± 0.50 对 2.22 ± 0.62，)和 OGTT 后 2 小时胰岛素（4.01 ± 0.77 与 3.74 ± 0.76，)和改进的 HOMA-IR (1.05 ± 0.53 vs. 0.85 ± 0.66,）。肠道微生物群分析表明，菊粉补充导致放线菌、双歧杆菌、双歧杆菌科、乳杆菌科、双歧杆菌、乳杆菌和厌氧菌在 3 个月和 6 个月时的相对丰度增加，而Alistipes的相对丰度下降。Spearman 相关分析显示，微生物群落的改变与葡萄糖和脂质代谢参数有关。结论. 菊粉补充剂可改善糖尿病前期的胰岛素抵抗，并对调节肠道微生物群组成发挥有益作用。这些发现表明胰岛素可能是一种潜在的新型且廉价的前驱糖尿病干预措施。