Association of Gut Microbiota Derived Metabolites (TMAO and SCFAs) with Insulin Resistance Among Patients with Metabolic Syndrome
Gut Microbiota Metabolites and Insulin Resistance in Metabolic Syndrome
DOI:
https://doi.org/10.69750/dmls.03.03.0198Keywords:
Gut microbiota, TMAO, short-chain fatty acids, insulin resistance, metabolic syndrome, HOMA-IRAbstract
Background: Gut microbiota-derived metabolites have emerged as key regulators of metabolic homeostasis, with increasing evidence linking them to insulin resistance and metabolic syndrome. Among these metabolites, trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs) exert opposing metabolic effects.
Objective: To evaluate the association between circulating levels of TMAO and SCFAs with insulin resistance in patients diagnosed with metabolic syndrome.
Methods: This cross-sectional study was conducted from May 2024 to March 2025 at Nishtar Medical University, Multan. A total of 70 adult patients with metabolic syndrome, diagnosed according to NCEP ATP III criteria, were enrolled. Fasting blood samples were collected to measure glucose, insulin, lipid profile, TMAO, and SCFAs using standardized biochemical techniques. Insulin resistance was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Statistical analysis included correlation and multivariable regression using SPSS version 26.
Results: The mean HOMA-IR was 5.9 ± 1.9, indicating significant insulin resistance. Elevated TMAO levels were observed in 65.7% of patients, while reduced SCFA levels were found in 61.4%. TMAO demonstrated a strong positive correlation with HOMA-IR (r = 0.59, p < 0.001), whereas SCFAs showed a significant negative correlation (r = −0.52, p < 0.001). Multivariable analysis identified TMAO as an independent predictor of insulin resistance (β = 0.38, p < 0.001), while butyrate exhibited a protective association (β = −0.34, p < 0.001).
Conclusion: Gut microbiota-derived metabolites are significantly associated with insulin resistance in metabolic syndrome. Elevated TMAO and reduced SCFAs contribute to metabolic dysfunction, highlighting their potential as biomarkers and therapeutic targets.
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