J Diabetes Res. 2018 Nov 12;2018:5205126. doi: 10.1155/2018/5205126. eCollection 2018.
Author information
- 1
- Department of Gastroenterology, "Sf. Spiridon" County Clinical Emergency Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
- 2
- Department of Pathophysiology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
- 3
- Department of Morpho-Functional Sciences I, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
- 4
- Department of Ophthalmology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
- 5
- Department of Internal Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
- 6
- 3rd Internal Medicine Clinic, "Sf. Spiridon" County Clinical Emergency Hospital, Iasi, Romania.
- 7
- Department of Morpho-Functional Sciences I, Discipline of Anatomy, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Abstract
The
prevalence of diabetes is steadily rising, and once it occurs, it can
cause multiple complications with a negative impact on the whole
organism. Complications of diabetes may be macrovascular: such as stroke
and ischemic heart disease as well as peripheral vascular and
microvascular diseases-retinopathy, nephropathy, and neuropathy. Key
factors that cause cardiovascular disease in people with diabetes
include hyperglycemia, dyslipidemia, obesity, insulin resistance,
inflammation, hypertension, autonomic dysfunction, and decreased
vascular response capacity. Microbes can be considered a complex
endocrine system capable of ensuring the proper functioning of the body
but are also responsible for the development of numerous pathologies
(diabetes, coronary syndromes, peripheral arterial disease, neoplasia,
Alzheimer's disease, and hepatic steatosis). Changes in the intestinal
microbiota may influence the host's sensitivity to insulin, body weight,
and lipid and carbohydrate metabolism. Dysbiosis causes activation of
proinflammatory mechanisms, metabolic toxicity, and insulin resistance.
Trimethylamine N-oxide (TMAO) is a microbial organic compound generated
by the large intestine, and its concentration increases in the blood
after ingestion of foods rich in L-carnitine and choline, such as red
meat, eggs, and fish. The interest for TMAO in cardiometabolic research
has recently emerged, given the preclinical evidence that reveals a link
between TMAO, diabetes, and cardiovascular complications. Intestinal
microbiota can be modulated by changing one's lifestyle but also by
antibiotic, probiotic, prebiotic, and fecal transplantation. The purpose
of this article is to highlight issues related to the involvement of
microbiota and trimethylamine N-oxide in the pathogenesis of diabetes
mellitus and cardiovascular disease. Better appreciation of the
interactions between food intake and intestinal floral-mediated
metabolism can provide clinical insights into the definition of
individuals with diabetic risk and cardiometabolic disease as well as
potential therapeutic targets for reducing the risk of progression of
the disease.
- PMID:
- 30539026
- PMCID:
- PMC6260408
- DOI:
- 10.1155/2018/5205126
