Examining the composition of gut microbiota in a South African population: a comparative study between type 2 diabetes mellitus patients and non-diabetic individuals

Abstract

Abstract Background Literature has highlighted the gut microbiota’s role in metabolic functions, suggesting a potential link between gut microbiota composition and T2DM. The purpose of the study was to identify microbial signatures unique to T2DM patients and non-diabetic individuals, to compare microbial profiles between the two groups and to investigate how gut microbiota may be related to inflammation associated with T2DM. Methods A cross-sectional study was conducted involving 51 T2DM patients and 99 non-diabetic South African individuals. Faecal samples were collected and analysed using 16S rRNA gene sequencing to characterize the gut microbiota. Blood samples were obtained to perform HbA1c, CRP and ferritin tests. Bioinformatic and statistical analyses were performed to identify differences in microbial composition and diversity between the two groups. Results The gut microbiota in T2DM patients was predominantly composed of Firmicutes (47.7%), Bacteroidota (37.5%), and Proteobacteria (11.4%), while the non-diabetic group showed a slightly different microbial profile with higher Bacteroidota (41.9%) and a notable presence of Actinobacteriota (4.5%). Abundant families in the T2DM group included Bacteroidaceae (22.8%), Prevotellaceae (7.4%), Enterobacteriaceae (7.4%), Erysipelotrichaceae (6.0%) and Lachnospiraceae (5.2%). The non-diabetic group exhibited dominant families such as Lachnospiraceae 26.7%, Prevotellaceae (25.3%), Bacteroidaceae (12.7%), Ruminococcaceae (9.5%) and Oscillospiraceae (3.8%). At the genus level, Bacteroides (22.8%), Escherichia-Shigella (5.0%), Holdemanella (4.8%), Phascolarctobacterium (3.2%) and Blautia (2.8%) were prevalent in the T2DM group, while Prevotella_9 (22.1%), Bacteroides (12.7%), Agathobacter (6.7%), Blautia (6.3%) and Faecalibacterium (5.1%) were dominant in the non-diabetic group. Differential abundance testing revealed 5 phyla, 16 families, and 25 genera that were either enriched/depleted in T2DM patients relative to non-diabetic individuals. The comparison of alpha diversity metrics between the two groups revealed significant differences across all four measures (P < 0.001), with non-diabetic individuals showing higher values than T2DM patients. HbA1c and CRP levels showed correlations with the relative abundance of various gut microbes at various phyla, family, and genus levels, as well as with all alpha diversity metrics. Conclusion The study revealed distinct differences in gut microbiota composition between T2DM patients and non-diabetic individuals, with T2DM patients showing a higher prevalence of certain phyla, families, and genera linked to metabolic dysregulation. Non-diabetic individuals exhibited greater microbial diversity and beneficial taxa, highlighting a potential protective microbial profile.