Clinical Scorecard: Characterization of Gut Microbiome Profiles and Metabolites Linked to Albuminuria in Individuals with Type 2 Diabetes
At a Glance
Category
Detail
Condition
Type 2 diabetes with albuminuria
Key Mechanisms
Gut microbiome species and plasma metabolites influence albuminuria progression
Target Population
Adults aged 50-64 with type 2 diabetes
Care Setting
Outpatient clinical and research settings with access to microbiome and metabolite analysis
Key Highlights
Three gut microbial species (Sellimonas intestinalis, Eggerthellales sp., Ellagibacter isourolithinifaciens) are associated with albuminuria in type 2 diabetes.
Thirty-six plasma metabolites correlate with these signature species, implicating metabolites like imidazole propionate and trigonelline in albuminuria progression.
Deep shotgun metagenomic sequencing combined with plasma metabolomics provides granular insight into gut microbiome-metabolite interactions linked to diabetic kidney damage.
Guideline-Based Recommendations
Diagnosis
Monitor albuminuria using urine albumin-creatinine ratio (ACR): normoalbuminuria (<3 mg/mmol), microalbuminuria (3-30 mg/mmol), macroalbuminuria (>30 mg/mmol).
Consider gut microbiome profiling and plasma metabolite analysis for research or advanced clinical assessment of albuminuria risk.
Management
Integrate albuminuria monitoring in comprehensive diabetes care to reduce risk of kidney disease and cardiovascular complications.
Target gut microbiome and metabolite pathways as potential future therapeutic strategies pending further research.
Monitoring & Follow-up
Regularly assess urinary albumin excretion to detect early kidney impairment in type 2 diabetes.
Monitor plasma metabolites linked to albuminuria progression in research contexts.
Risks
Albuminuria is associated with increased risk of chronic kidney disease progression and cardiovascular morbidity and mortality.
Patient & Prescribing Data
Adults with type 2 diabetes aged 50-64
Current management focuses on albuminuria monitoring; emerging evidence suggests gut microbiome and metabolite modulation may influence disease progression.
Clinical Best Practices
Use standardized urine albumin-creatinine ratio measurements for early detection of diabetic nephropathy.
Incorporate fasting blood sampling for plasma metabolite profiling in research or specialized clinical settings.
Collect and store fecal samples under controlled conditions for accurate gut microbiome analysis.
Recognize the potential role of gut microbiota-derived metabolites such as trigonelline and imidazole propionate in albuminuria progression.
by Yi-Ting Lin, Sergi Sayols-Baixeras, Tiscar Graells, Koen F Dekkers, Gabriel Baldanzi, Diem Nguyen, Anders Larsson, Tobias Rudholm Feldreich, Nynne Nielsen, Aron C Eklund, Jacob B Holm, H Bjørn Nielsen, Göran Bergström, J Gustav Smith, Andrei Malinovschi, Gunnar Engström, Marju Orho-Melander, Tove Fall, Johan Ärnlöv
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