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2017 ; 8
(2
): 293-307
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Effects of Acarbose on the Gut Microbiota of Prediabetic Patients: A Randomized,
Double-blind, Controlled Crossover Trial
#MMPMID28130771
Zhang X
; Fang Z
; Zhang C
; Xia H
; Jie Z
; Han X
; Chen Y
; Ji L
Diabetes Ther
2017[Apr]; 8
(2
): 293-307
PMID28130771
show ga
INTRODUCTION: The ?-glucosidase inhibitor acarbose is an efficacious medicine for
the treatment and prevention of type 2 diabetes mellitus (T2DM). However, the
response of gut microbiota to acarbose is important, as the microbiota may have a
critical role in the development of metabolic diseases, and acarbose is
metabolized exclusively within the gastrointestinal tract. We explored the
changes in the proportion and diversity of gut microbiota before and after
treatment with acarbose in patients with prediabetes. METHODS: We designed a
randomized, double-blind, controlled crossover trial in which 52 Chinese patients
with prediabetes by an oral glucose tolerance test (OGTT) with a BMI of
18-35 kg/m(2) were randomly allocated to treatment with acarbose or placebo. Gut
microbiota characterizations were determined with 16S rDNA-based high-throughput
sequencing. RESULTS: Of the 52 participants who entered the study, 40 (76.9%)
completed the protocol. On the basis of the operational taxonomic unit (OTU)
profiles, a total of 107 OTUs were significantly altered after acarbose
treatment, with 76 (71%) assigned to the order of Clostridiales. Ruminococcaceae
(15 OTUs) and Lachnospiraceae (22 OTUs) decreased in response to acarbose, and 48
OTUs increased by 12.8-fold, including Lactobacillaceae (8 of 9 belonging to
Lactobacillus), Ruminococcaceae (6 of 11 belonging to Faecalibacterium), and
Veillonellaceae (8 of 15 belonging to Dialister). At genera level, five
flourished after treatment with acarbose, including Lactobacillus and Dialister,
while Butyricicoccus, Phascolarctobacterium, and Ruminococcus were inhibited.
CONCLUSION: This study suggests that the benefits of acarbose for T2DM may
correlate with the selective modulation of the gut microbiota. TRIAL
REGISTRATION: Chinese Clinical Trial Register number, ChiCTR-TTRCC-13004112.
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