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Arterial Stiffness and the Gut Microbiome

5/7/2019 5:57:02 PM
Arterial stiffness is a measurement of vascular aging that only weakly relates to conventional cardiovascular risk factors but is an independent predictor of major cardiovascular events—especially in patients with metabolic syndrome. Contributing factors to the development of arterial stiffness include insulin resistance and systemic inflammation, both of which are modulated by the gut microbiome. In a study published in the European Heart Journal in 2018, researchers aimed to determine whether gut microbial composition was associated with arterial stiffness.

Study examines connection between artery health and microbiome

This cross-sectional study relied on data from 617 female twins in the TwinsUK registry. Pulse wave velocity (PWV) was used as the gold-standard measurement of arterial stiffness. Researchers evaluated associations between PWV and the loss of microbiome diversity, specific microbial taxonomic units, and circulating gut microbiome metabolites (phenylacetylglutamine, trimethylamine oxide [TMAO], and indoleproprionate [IPA]).
Results showed that PWV inversely correlated with gut microbiome diversity and with the abundance of 7 specific microbes in the gut, including 2 members from the butyrate-producing Ruminococcaceae family. These associations remained significant but attenuated after adjusting for microbiome-derived metabolites, suggesting that phenylacetylglutamine and IPA may partly mediate the association.   
Adjusted analyses showed that the majority of the effect of the gut microbiome on PWV was not mediated by obesity, higher visceral fat, or insulin resistance. After adjusting for age, body mass index, and mean arterial pressure, the overall proportion of variance explained by microbiome factors was 8.3% (95% CI, 4.32 – 12.4%). 

Monitoring microbiome health can potentially help identify, intervene with artery health status

It’s biologically plausible that an altered composition of the gut microbiome could contribute to endotoxemia, systemic inflammation, and cardiovascular disease, but the cross-sectional design of this study cannot establish causal relationships. Nevertheless, the authors of this study conclude that a proportion of cardiovascular risk not explained by traditional risk factors might be captured by characterizing the gut microbiome and may help identify more patients at risk of major cardiovascular events. The gut microbiome is modifiable by diet and lifestyle, making this a clinically relevant finding.  
Menni C, Lin C, Cecelja M et al. Gut microbial diversity is associated with lower arterial stiffness in women. Eur Heart J. 2018; 39: 2390-2397.

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