Association of intestinal microbiota markers and dietary pattern in Chinese patients with type 2 diabetes: The Henan rural cohort study

Studies on intestinal microbiota in Chinese type 2 diabetes mellitus (T2DM) patients are scarce and correlation studies with dietary intake are lacking. The case-control study included 150 participants (74 T2DM patients and 76 controls) and microbiome analysis was performed using 16S rDNA sequencing. Principal component analysis was used to determine dietary patterns and correlation analysis was used to evaluate the associations between microbiota diversity, T2DM indicators and dietary variables. Compared to controls, the T2DM group had different gut flora characteristics, including lower alpha diversity, higher Firmicutes/Bacteroidetes ratios, statistically significant beta diversity and other specific bacterial species differences. Gut microbiota was associated with several diabetes-related metabolic markers including HOMA2-beta, fasting plasma glucose, HbA1c and fasting insulin. Significant associations were also observed between dietary intake pattern and gut flora. The animal foods pattern scores were positively correlated with the relative abundance of the phylum Fusobacteria, and the vegetarian diet pattern scores were positively correlated with the relative abundance of the phylum Actinobacteria. Phylum Actinobacteria mediated the association of vegetarian diet pattern with fasting insulin and HOMA2-beta (all P < 0.05). Composition of intestinal microbiota in Chinese T2DM patients differs from that of control population, and the intestinal flora is affected by dietary intake while being associated with several diabetes-related metabolic markers. The gut microbiota may play an important role in linking dietary intake and the etiology of T2DM.