TYPE 2 diabetes mellitus (T2DM) combined with coronary atherosclerotic heart disease was associated with distinct gut microbiota and metabolomic signatures in a new pilot study, highlighting potential biomarkers linked to cardiometabolic disease.
Researchers Map Gut Microbiota Changes
Researchers analysed faecal and plasma samples from 30 participants, including 10 healthy controls, 10 patients with type 2 diabetes mellitus (T2DM), and 10 patients with T2DM combined with coronary atherosclerotic heart disease (T2DM-CAD).
Using metagenomic sequencing and liquid chromatography–mass spectrometry metabolomics, the investigators explored how gut microbiota and microbial metabolites differed between the groups.
Gut Microbiota Alterations in T2DM-CAD
The researchers identified several gut microbial species with potential diagnostic significance. Among the most notable were Prevotella disiens, Bacteroides sp._CAG_875, Sutterella wadsworthensis, Paraprevotella clara, and Anaerobutyricum hallii.
Random forest and receiver operating characteristic analyses suggested that Bacteroides sp._CAG_875 may be particularly important, as it distinguished both healthy controls from T2DM-CAD and T2DM from T2DM-CAD. The authors noted that members of the Bacteroides genus have previously been linked to diabetes, inflammation, and cholesterol metabolism.
Although overall microbial diversity did not differ significantly between groups, specific bacterial taxa varied substantially, supporting the idea that functional microbial shifts may occur despite relatively stable global diversity.
Metabolomic Signatures Linked to Cardiometabolic Disease
Metabolomic analysis identified 42 differentially abundant metabolites across the three groups. Several metabolites demonstrated potential diagnostic value, including fructose, gallic acid, pyroglutamic acid, adipic acid, suberic acid, and 12-ketolithocholic acid (12-ketoLCA).
Notably, 12-ketoLCA emerged as a potential biomarker in both comparisons involving T2DM-CAD. The metabolite has previously been associated with bile acid metabolism and high-fat diet-induced metabolic dysfunction.
The study also identified significant alterations in metabolic pathways related to amino acid metabolism, linoleic acid metabolism, and alanine, aspartate, and glutamate metabolism, pathways closely linked to insulin resistance and cardiovascular disease.
Gut Microbiota–Metabolite Interactions
Further correlation analyses revealed associations between specific gut microbes and metabolites.
The authors suggested these gut microbiota–metabolite interactions may contribute to the “gut–heart axis” implicated in diabetes-related cardiovascular complications.
Limitations and Future Directions
The investigators acknowledged several limitations, including the small sample size and lack of mechanistic validation. They emphasised that the identified gut microbiota and metabolites should currently be regarded as candidate biomarkers rather than definitive pathogenic drivers.
Larger prospective studies are now needed to determine whether these microbial and metabolic signatures contribute directly to disease development or reflect broader cardiometabolic dysfunction.
Reference
Huang L et al. The gut microbiota and metabolomics in the pathogenesis of type 2 diabetes mellitus combined with coronary atherosclerotic heart disease. Sci Rep. 2026;DOI: 10.1038/s41598-026-51805-3.
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