Analysis of Gut Microbiota and Metabolic Indicators in Patients with Obesity and Type 2 Diabetes Mellitus

Vafoyev Shakhzod Farkhod ugli; Shagazatova Barno Khabibullayevna

Authors

Vafoyev Shakhzod Farkhod ugli Assistant, Department of Internal Medicine and Endocrinology, Tashkent State Medical University, Tashkent, Uzbekistan
Shagazatova Barno Khabibullayevna Professor, Doctor of Medical Sciences, Professor, Department of Internal Medicine and Endocrinology, Tashkent State Medical University, Tashkent, Uzbekistan

Keywords:

Gut microbiota, obesity, type 2 diabetes mellitus, GLP-1 receptor agonist, semaglutide, Faecalibacterium prausnitzii, dysbiosis, Kolonoflor-16, ROC analysis

Abstract

The aim of this article is to compare gut microbiota composition together with anthropometric and biochemical indicators between patients with obesity (prior to semaglutide administration) and patients with early T2DM, and to evaluate the discriminatory value of the studied markers. Materials and methods. A cross-sectional study included 51 adults: an obesity group (n = 44; 36 women, 8 men) examined before initiation of the GLP-1 receptor agonist semaglutide, and a T2DM group (n = 7 women) diagnosed within the preceding three years who had received oral hypoglycaemic agents previously but none during the last three months. Anthropometric data and a biochemical panel (glucose, hepatic enzymes, lipid profile, renal markers) were obtained. Results. Fasting glucose was, by design, markedly higher in the T2DM group (8.84 ± 0.49 vs 4.80 ± 0.53 mmol/L; p < 0.001), whereas anthropometric and lipid indicators did not differ significantly. The T2DM group showed higher abundance of Faecalibacterium prausnitzii (9.43 ± 1.90 vs 7.70 ± 1.36 lg Copy/ml; p = 0.023), Klebsiella oxytoca (p = 0.015) and Clostridium difficile (p = 0.018), with a trend toward higher Bifidobacterium spp. and total bacterial mass, while Escherichia coli (p = 0.017) and Enterococcus spp. (p = 0.036) were higher in the obesity group. Fasting glucose correlated positively with Clostridium perfringens (ρ = 0.36), Clostridium difficile (ρ = 0.34) and F. prausnitzii (ρ = 0.29), and BMI with Candida spp. (ρ = 0.31). In ROC analysis, F. prausnitzii (AUC = 0.77), urea (AUC = 0.73) and Bifidobacterium spp. (AUC = 0.71) showed moderate discrimination between the groups. Conclusion. Early, treatment-naïve T2DM and pre-treatment obesity are associated with distinct intestinal microbial signatures detectable by targeted PCR profiling. Selected taxa, in particular F. prausnitzii and Bifidobacterium spp., warrant further evaluation as adjunct biomarkers of metabolic phenotype.

References

Xuan W, Ou Y, Chen W, Huang L, Wen C, Huang G, et al. Faecalibacterium prausnitzii improves lipid metabolism disorder and insulin resistance in type 2 diabetic mice. Br J Biomed Sci. 2023;80:10794. doi:10.3389/bjbs.2023.10794.

Byndloss M, Devkota S, Duca F, Niess JH, Nieuwdorp M, Orho-Melander M, et al. The gut microbiota and diabetes: research, translation, and clinical applications—2023 Diabetes, Diabetes Care, and Diabetologia Expert Forum. Diabetes Care. 2024;47(9):1491–1508. doi:10.2337/dci24-0052.

Gofron KK, Wasilewski A, Małgorzewicz S. Effects of GLP-1 analogues and agonists on the gut microbiota: a systematic review. Nutrients. 2025;17(8):1303. doi:10.3390/nu17081303.

Liang L, Su X, Guan Y, Wu B, Zhang X, Nian X. Correlation between intestinal flora and GLP-1 receptor agonist dulaglutide in type 2 diabetes mellitus treatment—a preliminary longitudinal study. iScience. 2024;27(5):109784. doi:10.1016/j.isci.2024.109784.

Mao T, Zhang C, Yang S, Bi Y, Li M, Yu J. Semaglutide alters gut microbiota and improves NAFLD in db/db mice. Biochem Biophys Res Commun. 2024;710:149882. doi:10.1016/j.bbrc.2024.149882.

Xiong C, Wu J, Ma Y, Li N, Wang X, Li Y, Ding X. Effects of glucagon-like peptide-1 receptor agonists on gut microbiota in dehydroepiandrosterone-induced polycystic ovary syndrome mice: compared evaluation of liraglutide and semaglutide intervention. Diabetes Metab Syndr Obes. 2024;17:865–880. doi:10.2147/DMSO.S451129.

Zhao L, Qiu Y, Zhang P, Wu X, Zhao Z, Deng X, et al. Gut microbiota mediates positive effects of liraglutide on dyslipidemia in mice fed a high-fat diet. Front Nutr. 2022;9:1048693. doi:10.3389/fnut.2022.1048693.

Rao Y, Kuang Z, Li C, Guo S, Xu Y, Zhao D, et al. Gut Akkermansia muciniphila ameliorates metabolic dysfunction-associated fatty liver disease by regulating the metabolism of L-aspartate via the gut–liver axis. Gut Microbes. 2021;13(1):1–19. doi:10.1080/19490976.2021.1927633.

Feng S, Wang W, Zhang X, Helal SE, Peng N, Zhang Z. Investigating the role of Akkermansia muciniphila Akk11 in modulating obesity and intestinal dysbiosis: a comparative study of live and pasteurized treatments. Front Microbiol. 2025;16:1638771. doi:10.3389/fmicb.2025.1638771.

Lin XQ, Chen W, Ma K, Liu ZZ, Gao Y, Zhang JG, et al. Akkermansia muciniphila suppresses high-fat diet-induced obesity and related metabolic disorders in beagles. Int J Mol Sci. 2022;23(1):280. doi:10.3390/ijms23010280.

Q. S. Makhmudov, “Forms of Quick Management of Manufacturing in the Conditions of Market Relations,” 2023.

K. Makhmudov, “Key Concepts Regarding the Quality of Services and Its Management,” 2023.

K. Makhmudov, “The Need to Introduce Quality Systems in the Field of Services,” European Journal of Business Startups and Open Society, vol. 2, no. 7, pp. 11–14.

I. Ismoilov, “Alisher Navoiyning ‘Saddi Iskandariy’ dostoni debochasi badiiyati,” Oltin Bitiglar–Golden Scripts, vol. 1, no. 1, 2021.

I. Ismoilov, “Tafsirlarda Iskandar mavzusiga oid talqinlar,” Oltin Bitiglar–Golden Scripts, vol. 2, no. 2, 2021.