Individuals with obesity have an increased prevalence of the Bacteroides 2 (Bact2) enterotype, one of four classifications of gut microbiota composition that is associated with systemic inflammation and disease. However, individuals with obesity who are taking statin therapy have a lower prevalence of this dysbiosis than individuals with obesity who are not receiving statins. Causality has not been established, but the possibility that statin therapy might have gut microbiota-modulatory benefits should now be tested.
Alterations in gut microbiota have been linked with cardiovascular diseases, including atherosclerosis, heart failure and hypertension. In a new study, researchers analysed faecal samples from 888 individuals in the MetaCardis Body Mass Index Spectrum cohort. Among the individuals who were not taking statins, those with obesity (BMI ≥30) had a higher prevalence of the Bact2 enterotype (17.7%) than those who were lean or overweight (BMI <30; 3.9%). The Bact2 enterotype is characterized by a high proportion of Bacteroides and a low proportion of Faecalibacterium. Individuals with this enterotype tend to have loose stools and a higher plasma concentration of the inflammatory marker C-reactive protein than individuals with other enterotypes.
The researchers also found that individuals with obesity who were receiving statin therapy had a lower prevalence of the Bact2 enterotype (5.9%) than individuals with obesity who were not taking statins (17.7%). This finding was validated in an independent cohort of 2,345 individuals from the Flemish Gut Flora Project.
statin therapy might have gut microbiota-modulatory benefits
These findings raise the intriguing possibility that statin therapy might have a beneficial modulatory effect on the gut microbiota. However, causality cannot be determined from the data reported because, for example, statin users might also have engaged in other health-promoting behaviours. In an accompanying News & Views article, Peter Libby calls for “a large-scale clinical trial to determine whether statins lead to a reduced prevalence of the Bact2 enterotype in obese participants who would not otherwise receive statins”.
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Original article
Vieira-Silva, S. et al. Statin therapy is associated with lower prevalence of gut microbiota dysbiosis. Nature https://doi.org/10.1038/s41586-020-2269-x (2020)
Related article
Tang, W. H. W. et al. Dietary metabolism, the gut microbiome, and heart failure. Nat. Rev. Cardiol. 16, 137–154 (2019)
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Lim, G.B. Improved gut microbiota profile in individuals with obesity taking statins. Nat Rev Cardiol 17, 385 (2020). https://doi.org/10.1038/s41569-020-0396-6
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DOI: https://doi.org/10.1038/s41569-020-0396-6
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