Association Between Nitrate‐Reducing Oral Bacteria and Cardiometabolic Outcomes: Results From ORIGINS

Author:

Goh Charlene E.1,Trinh Pauline2,Colombo Paolo C.3,Genkinger Jeanine M.24,Mathema Barun2,Uhlemann Anne‐Catrin5,LeDuc Charles6,Leibel Rudolph6,Rosenbaum Michael6,Paster Bruce J.78,Desvarieux Moise29,Papapanou Panos N.10,Jacobs David R.11,Demmer Ryan T.11

Affiliation:

1. Faculty of Dentistry National University of Singapore Singapore

2. Department of Epidemiology Columbia University Mailman School of Public Health New York NY

3. Division of Cardiology Department of Medicine Columbia University New York NY

4. Herbert Irving Comprehensive Cancer Center Columbia University Irving Medical Center New York NY

5. Division of Infectious Diseases and Microbiome and Pathogen Genomics Core Department of Medicine Columbia University Irving Medical Center New York NY

6. Division of Molecular Genetics Departments of Pediatrics and Medicine Columbia University New York NY

7. The Forsyth Institute Cambridge MA

8. Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine Boston MA

9. INSERM UMR 1153 Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS) METHODS Core Paris France

10. Division of Periodontics Section of Oral and Diagnostic Sciences College of Dental Medicine Columbia University New York NY

11. Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN

Abstract

Background The enterosalivary nitrate‐nitrite‐nitric oxide pathway is an alternative pathway of nitric oxide generation, potentially linking the oral microbiome to insulin resistance and blood pressure (BP). We hypothesized that increased abundance of nitrate‐reducing oral bacteria would be associated with lower levels of cardiometabolic risk cross‐sectionally. Methods and Results ORIGINS (Oral Infections, Glucose Intolerance, and Insulin Resistance Study) enrolled 300 diabetes mellitus–free adults aged 20 to 55 years (mean=34±10 years) (78% women). Microbial DNA was extracted from subgingival dental plaque (n=281) and V3–V4 regions of the 16S rRNA gene were sequenced to measure the relative abundances of 20 a priori selected taxa with nitrate‐reducing capacity. Standardized scores of each taxon's relative abundance were summed, producing a nitrate‐reducing taxa summary score ( NO 3 TSS ) for each participant. Natural log‐transformed homeostatic model assessment of insulin resistance, plasma glucose, systolic BP, and diastolic BP were regressed on NO 3 TSS in multivariable linear regressions; prediabetes mellitus and hypertension prevalence were regressed on NO 3 TSS using modified Poisson regression models. Nitrate‐reducing bacterial species represented 20±16% of all measured taxa. After multivariable adjustment, a 1‐ SD increase in NO 3 TSS , was associated with a −0.09 (95% CI , −0.15 to −0.03) and −1.03 mg/dL (95% CI , −1.903 to −0.16) lower natural log‐transformed homeostatic model assessment of insulin resistance and plasma glucose, respectively. NO 3 TSS was associated with systolic BP only among patients without hypertension; 1‐ SD increase in NO 3 TSS was associated with −1.53 (95% CI , −2.82 to −0.24) mm Hg lower mean systolic BP. No associations were observed with prediabetes mellitus and hypertension. Conclusions A higher relative abundance of oral nitrate‐reducing bacteria was associated with lower insulin resistance and plasma glucose in the full cohort and with mean systolic BP in participants with normotension.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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