May 2018 Hot Topic: The Microbiome, Butyrate, and Arterial Stiffness

A new twin study is the first to examine women’s cardiovascular risk factors and the microbiome.1 Researchers examined arterial stiffness and the composition of the gut microbiome in 617 white, middle-aged, female twins from the TwinsUK Registry. Diversity of the gut microbiome explained over 8% of the risk, which was significant.  Even including visceral adiposity and insulin resistance assessment only explained 1.8% of the variation in arterial stiffness, suggesting that the microbiome is a major factor. Lower microbial diversity correlated with higher arterial stiffness. One bacterial family may be especially protective: Ruminococcaceae.1

Ruminococcaceae are known to produce butyrate.2 Changes in butyrate production may be a mechanism by which fecal transplants have led to improvements in patients with metabolic syndrome, although those improvements were not long-lasting.3 In all animals, diet plays a role in the ratio of butyrate-producing bacteria in the microbiome.4

In addition, evidence is accumulating that capsaicin may have a specific protective role for increasing Ruminococcaceae populations. In at least one study, dietary capsaicin reduced metabolic endotoxemia resulting from dysbiosis in mice, while also significantly increasing butyrate-producing Ruminococcaceae and Lachnospiraceae and decreasing lipopolysaccharide (LPS)-producing bacteria.5 Higher dietary levels of capsaicin have been linked to cardiometabolic health,6 and the microbiome may explain why.

 In nearly half of patients who experience a heart attack, the first sign of a cardiometabolic issue is the heart attack itself.7 For primary care clinicians, this offers an enormous opportunity to provide value for patients: cardiometabolic health promotion may just start with fixing the gut.

References

  1. Menni C, Lin C, Cecelja C, et al. Gut microbial diversity is associated with lower arterial stiffness in women [published online May 9, 2018]. Eur Heart J. doi:1093/eurheartj/ehy226.
  2. Vital M, Howe AC, Tiedje JM. Revealing the bacterial butyrate synthesis pathways by analyzing (meta)genomic data. MBio. 2014;5(2):e00889-14. doi:1128/mBio.00889-14.
  3. Kootte RS, Levin E, Salojärvi J, et al. Improvement of insulin sensitivity after lean donor feces in metabolic syndrome is driven by baseline intestinal microbiota composition. Cell Metab. 2017;26(4):611-619.e6. doi:1016/j.cmet.2017.09.008.
  4. Vital M, Gao J, Rizzo M, Harrison T, Tiedje JM. Diet is a major factor governing the fecal butyrate-producing community structure across Mammalia, Avesand Reptilia.  ISME J. 2015;9(4):832-843. doi:1038/ismej.2014.179.
  5. Kang C, Wang B, Kaliannan K, et al. Gut microbiota mediates the protective effects of dietary capsaicin against chronic low-grade inflammation and associated obesity induced by high-fat diet. MBio. 2017;8(3):e00470-17. doi:1128/mBio.00470-17.
  6. Sun F, Xiong S, Zhu Z. Dietary capsaicin protects cardiometabolic organs from dysfunction. Nutrients. 2016;8(5):E174. doi:3390/nu8050174.
  7. Zhang Z-M, Rautaharju PM, Prineas RJ, et al. Race and sex differences in the incidence and prognostic significance of silent myocardial infarction in the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2016;133(22):2141-2148. doi:1161/CIRCULATIONAHA.115.021177.

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