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  • Review Article
  • Published:

The gut microbiome, diet, and links to cardiometabolic and chronic disorders

Nature Reviews Nephrology volume 12, pages 169–181 (2016)Cite this article

Subjects

Key Points

  • Dietary modifications (in particular high-fat feeding) can induce changes in the microbiota that might impact on host-associated metabolic disorders, such as insulin resistance

  • Germ-free mice exhibit reduced adiposity and fat pads compared to conventionally housed mice, thus implicating the gut microbiota in energy storage

  • An obese phenotype is transmissible via faecal transfer from obese mice or humans to germ-free mice

  • Metabolites that are derived from the gut microbiota, such as trimethylamine N-oxide (TMAO), are associated with poor cardiovascular outcomes in patients with cardiovascular disease

  • TMAO is increased in patients with chronic kidney disease (CKD) before haemodialysis and decreases after kidney transplantation

  • TMAO is associated with poor cardiovascular outcomes in patients with CKD

Abstract

Cardiometabolic diseases (CMDs) have been associated with changes in the composition of the gut microbiota, with links between the host environment and microbiota identified in preclinical models. High-throughput sequencing technology has facilitated in-depth studies of the gut microbiota, bacterial-derived metabolites, and their association with CMDs. Such strategies have shown that patients with CMDs frequently exhibit enrichment or depletion of certain bacterial groups in their resident microbiota compared to healthy individuals. Furthermore, the ability to transfer resident gut microbiota from mice or humans into germ-free mouse models, or between human patients, has enabled researchers to characterize the causative role of the gut microbiota in CMDs. These approaches have helped identify that dietary intake of choline, which is metabolized by the gut microbiota, is associated with cardiovascular outcomes in mice and humans. Trimethylamine N-oxide (TMAO) — a metabolite derived from the gut microbiota — is also associated with poor cardiovascular outcomes in patients with cardiovascular disease and is elevated in patients with chronic kidney disease (CKD). TMAO might represent a biomarker that links the environment and microbiota with CKD. This Review summarizes data suggesting a link between the gut microbiota and derived metabolites with food intake patterns, metabolic alterations, and chronic CMDs.

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Figure 1: Insights into the role of the gut microbiota from germ-free mice and faecal transfer experiments.
Figure 2: Links between dietary intake, gut microbiota, host biology and tissue damage.

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Acknowledgements

The authors would like to thank the FP7 MetaCardis project (grant number HEALTH.F4_2012_305,312), the Coeur et Artère association (Fondacoeur), the AP–HP Microbaria project, and the National Agency of Research, which support their research into the gut microbiota and cardiometabolic health. The authors would also like to thank Brandon Kayser (Institute of Cardiometabolism and Nutrition, Pitié-Salpêtrière Hospital, Paris) for language editing the manuscript before submission.

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  1. Institute of Cardiometabolism and Nutrition (ICAN), Assistance Publique–Hôpitaux de Paris, INSERM, Sorbonne Université, Paris 6, Pitié–Salpêtrière hospital, Paris, F-75013, France

    Judith Aron-Wisnewsky & Karine Clément

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  1. Judith Aron-Wisnewsky
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J.A.-W. wrote the article. J.A.-W. and K.C. researched the data for the article, provided substantial contribution to discussions of the content, and contributed equally to review and/or editing of the manuscript before submission.

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Correspondence to Judith Aron-Wisnewsky or Karine Clément.

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Aron-Wisnewsky, J., Clément, K. The gut microbiome, diet, and links to cardiometabolic and chronic disorders. Nat Rev Nephrol 12, 169–181 (2016). https://doi.org/10.1038/nrneph.2015.191

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