CHANGES IN THE GUT MICROBIOTA UNDER THE INFLUENCE OF METFORMIN, PIOGLITAZONE, AND LEVOTHYROXINE IN OVERWEIGHT PATIENTS WITH TYPE 2 DIABETES MELLITUS AND HYPOTHYROIDISM.

Authors

DOI:

https://doi.org/10.21856/j-PEP.2022.4.06

Keywords:

gut microbiota, gut microbiota in patients with type 2 diabetes mellitus, gut microbiota and hypothyroidism

Abstract

Background. Discussion about the role of gut microbiota (GM) in patients with type 2 diabetes mellitus (T2D) gives reasons for the appearance of new questions. This challenge becomes even more difficult especially in the case of concomitant pathologies. First of all, this refers to such comorbidity as hypothyroidism and obesity.

Materials and Methods. We examined 36 patients (19 women and 17 men) aged from 35 to 67 yrs, with body mass index (BMI) 27.73±0.28 kg/m2 who were diagnosed with T2D and hypothyroidism for the first time. Patients were given an individualized dose of levothyroxine (25-150 mcg/day), metformin (500-2000 mg/day), and pioglitazone (15-30 mg/day). Patients were examined before and after 6 months of the above therapy, body weight and height were checked; thyroid stimulating hormone, free thyroxine, free triiodothyronine, fasting blood glucose and insulin, HOMA-IR index, HbA1c levels were assessed. GM was assessed by bacterial levels of Firmicutes, Bacteroidetes, Actinobacteria, Lactobacilus spp., Bifidobacterium spp., Bacteroides fragilis, Вacteroides thetaiotaomicron, Akkermansia muciniphila, and Firmicutes/Bacteroidetes ratio.

Results. Under the influence of the chosen therapy, all patients achieved euthyroidism and improvement of glycemic profile. Examination of GM before the start of therapy revealed that slightly more than half of the total bacterial mass, namely 51.21% accounted for Bacteroidetes, 31.11% – for Firmicutes, 5.31% – for Actinobacteria, 12.37% for other types. After the therapy and the achievement of compensation, this ratio changed towards the emergence of a wider diversity of the microbiome by reducing the proportion of Bacteroidetes to 41.68 % and increasing Firmicutes to 36.86 %, Actinobacteria – to 7.24 % and smaller groups of bacteria combined under the general group "others" – to 14.22 %.

Conclusions. Our clinical study for the first time revealed specific quantitative changes in the structure of gut microbiota in overweight patients with type 2 diabetes mellitus and hypothyroidism after routine semi-annual complex treatment. With the increase in the content of Actinobacteria and the "others" group, gut microbiota showed a shift towards an increase in the Firmicutes profile and adjacent reduction of Bacteroidetes. Clarification of the influence of each of the drugs (metformin, pioglitazone, levothyroxine) on certain cultures of gut microbiota are important tasks of further research in order to establish unknown pathogenetic links of type 2 diabetes mellitus and hypothyroidism, as well as specific markers at the stages of development of these diseases and their compensation.

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Published

2022-12-15

How to Cite

Москва, Х., Кіхтяк, О., Лаповець, Л., & Урбанович, А. (2022). CHANGES IN THE GUT MICROBIOTA UNDER THE INFLUENCE OF METFORMIN, PIOGLITAZONE, AND LEVOTHYROXINE IN OVERWEIGHT PATIENTS WITH TYPE 2 DIABETES MELLITUS AND HYPOTHYROIDISM. Problems of Endocrine Pathology, 79(4), 45-51. https://doi.org/10.21856/j-PEP.2022.4.06

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Section

CLINICAL ENDOCRINOLOGY