Prebiotic effect of inulin-type fructans on faecal microbiota and short-chain fatty acids in type 2 diabetes: a randomised controlled trial

Eline Birkeland, Sedegheh Gharagozlian, Kåre I Birkeland, Jørgen Valeur, Ingrid Måge, Ida Rud, Anne-Marie Aas, Eline Birkeland, Sedegheh Gharagozlian, Kåre I Birkeland, Jørgen Valeur, Ingrid Måge, Ida Rud, Anne-Marie Aas

Abstract

Purpose: Compared to a healthy population, the gut microbiota in type 2 diabetes presents with several unfavourable features that may impair glucose regulation. The aim of this study was to evaluate the prebiotic effect of inulin-type fructans on the faecal microbiota and short-chain fatty acids (SCFA) in patients with type 2 diabetes.

Methods: The study was a placebo controlled crossover study, where 25 patients (15 men) aged 41-71 years consumed 16 g of inulin-type fructans (a mixture of oligofructose and inulin) and 16-g placebo (maltodextrin) for 6 weeks in randomised order. A 4-week washout separated the 6 weeks treatments. The faecal microbiota was analysed by high-throughput 16S rRNA amplicon sequencing and SCFA in faeces were analysed using vacuum distillation followed by gas chromatography.

Results: Treatment with inulin-type fructans induced moderate changes in the faecal microbiota composition (1.5%, p = 0.045). A bifidogenic effect was most prominent, with highest positive effect on operational taxonomic units (OTUs) of Bifidobacterium adolescentis, followed by OTUs of Bacteroides. Significantly higher faecal concentrations of total SCFA, acetic acid and propionic acid were detected after prebiotic consumption compared to placebo. The prebiotic fibre had no effects on the concentration of butyric acid or on the overall microbial diversity.

Conclusion: Six weeks supplementation with inulin-type fructans had a significant bifidogenic effect and induced increased concentrations of faecal SCFA, without changing faecal microbial diversity. Our findings suggest a moderate potential of inulin-type fructans to improve gut microbiota composition and to increase microbial fermentation in type 2 diabetes.

Trial registration: The trial is registered at clinicaltrials.gov (NCT02569684).

Keywords: 16S rRNA sequencing; Faecal bacteria; Prebiotics; SCFA; Type 2 diabetes.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Relative abundance (%) of the dominating phyla in faeces of the participants at baseline
Fig. 2
Fig. 2
OTUs affected by the prebiotic intervention for 6 weeks sorted by effect size. Effect size is the differences between prebiotic intervention period compared to placebo period /baseline (log2). Dominating OTUs (> 0.1%) are indicated in bold, and the relative average abundance of the OTUs is included at the right. Brackets indicate candidate taxonomy. Bars are coloured according to representative phylum
Fig. 3
Fig. 3
Microbial diversity shown as number of observed OTUs between prebiotics and placebo at baseline (0w) and after treatment period of 6 weeks (6w)
Fig. 4
Fig. 4
Heatmap of OTUs related to SCFA by PLS regression. Only OTUs affected by the prebiotic intervention are presented and sorted by their effect sizes (as in Fig. 2). Correlation is estimated with Spearman’s rho coefficient, where red is a positive and blue is a negative relation. Asterisk indicates significant relationship (VIP > 1.2). Dominating OTUs (> 0.1%) are indicated in bold

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