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. 2022 Jun 7:15:1715-1724.
doi: 10.2147/DMSO.S362715. eCollection 2022.

Imidazole Propionate is Increased in Diabetes and Associated with Stool Consistency

Bowen Wu  1 , Li Tan  2 , Weihua Wang  3 , Xingzhong Feng  4 , Dan Yan  1   5   6
Affiliations

Imidazole Propionate is Increased in Diabetes and Associated with Stool Consistency

Bowen Wu et al. Diabetes Metab Syndr Obes. .

Abstract

Background: Imidazole Propionate (ImP) is a new marker of Type 2 diabetes mellitus (T2DM), which can induce impaired glucose metabolism and weaken the efficacy of metformin. An extensive exploration into literature suggests that ImP may be associated with stool consistency.

Purpose: Through an in-depth study of the relationship between stool consistency, bile acids, fecal microbiota and ImP, we intend to explore the mechanism driving the ImP content difference in T2DM.

Patients under study and methods: This is a single-center, prospective, cross-sectional study. Plasma ImP and stool consistency were analyzed among 96 diabetic subjects and 45 healthy subjects. All subjects were divided into the stool consistency normal (N) group and the stool consistency abnormal group, of which the abnormal group was sub-divided into the hard stool (H) group and the soft stool (S) group. After identifying the correlation between ImP and stool consistency, we analyzed the influence of bile acids and fecal microbiota on ImP in diabetic subjects.

Results: For T2DM patients, the ImP level of the abnormal stool consistency group was significantly higher than that of the normal stool consistency group (P < 0.001). Results were verified in 45 healthy subjects (P = 0.002). ImP was significantly associated with taurocholic acid (TCA) (P = 0.003) in feces, taurodeoxycholate (TDCA) (P = 0.003), glycochenodeoxycholate (GCDCA) (P = 0.021), and glycocholic acid (GCA) (P = 0.031) in plasma. The Shannon index of Group N was significantly higher than that of Group H (P = 0.041) and Group S (P = 0.003).

Conclusion: ImP was higher in diabetic patients with abnormal stool consistency than in those with normal stool consistency, which was related to the proportion of bile acids and fecal microbial structure. These findings may improve our understanding of ImP and contribute to the treatment of T2DM by improving stool consistency.

Keywords: ImP; T2DM; bile acids; stool consistency.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Imidazole propionate is associated with the stool consistency. (A and B) Plasma levels of imidazole propionate (ImP) in subjects with Type 2 diabetes divided according to the stool consistency. (C) Plasma levels of ImP in healthy subjects divided according to the stool consistency. **P < 0.01, ***P < 0.001.
Figure 2
Figure 2
Imidazole propionate is associated with bile acids. (A) Imidazole propionate (ImP) level of subjects with LCA ≤ 30% was significantly higher than that of those with LCA > 30%. (B) Subjects with CDCA ≥ 5% had significantly higher ImP levels than those with CDCA < 5%. **P < 0.01.
Figure 3
Figure 3
Classification of microbial diversity in patients with different fecal consistencies. (A) The Shannon index of group N was significantly higher than that of Group H and Group S. (B) These three groups were separated into different clusters in the UniFrac PCoA. (C and D) Bar plots of the relative abundances of the three groups at the phylum level and the genus level. *P < 0.05, **P < 0.01.
See this image and copyright information in PMC

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