Causal association of oral microbiome characteristics with type 2 diabetes and myocardial infarction: a Mendelian randomization study_Chinese Journal of Evidence-Based Medicine

Authors：

CUI Jing ¹ , WANG Wenting ¹ , XU Qian ¹ , ZHU Mengmeng ¹ , LI Yiwen ² ,  LIU Yanfei ^1,3 ,  LIU Yue ¹

1. National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, P. R. China;
2. Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100078, P. R. China;
3. The Second Department of Gerontology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China;

Corresponding author：

LIU Yanfei, Email: yanfeitcm@163.com; LIU Yue, Email: liuyueheart@hotmail.com

Keywords：

Oral microbiome; Myocardial infarction; Type 2 diabetes; Mendelian randomization

DOI：

10.7507/1672-2531.202411021

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective Using the whole genome association study (GWAS) data, Mendel randomization (MR) method was used to find the causal relationship between oral flora and type 2 diabetes (T2D) and myocardial infarction (MI). Methods Genetic association data of oral microbiota were selected from the Chinese 4D-SZ cohort GWAS dataset, and T2D and MI outcome data were obtained from a large-scale cohort study in BioBank Japan. Four methods, including inverse variance weighting (IVW), were used to analyze the causal relationship between exposure and outcomes. Sensitivity analysis was conducted on significant MR results to further validate the robustness of the results. Results The results showed a total of 24 species of dorsal tongue flora and 13 species of salivary flora with a potential causal relationship with T2D. There were 12 species each of dorsal tongue and salivary flora with a potential causal relationship with MI.A total of 8 oral flora were found on the dorsum of the tongue and saliva that could affect both T2D and MI, namely Saccharimonadaceae, Treponemataceae, Prevotella, Haemophilus, Lachnoanaerobaculum, Campylobacter_A, Neisseria, and Streptococcus. Conclusion We identified 8 oral flora causally associated with both T2D and MI, suggesting that diabetes may play a role in promoting the progression of myocardial infarction by affecting the above oral flora.

1.	Roth GA, Johnson C, Abajobir A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol, 2017, 70(1): 1-25.
2.	Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics-2019 update: a report from the american heart association. Circulation, 2019, 139(10): e56-e528.
3.	Rawshani A, Rawshani A, Franzén S, et al. Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med, 2017, 376(15): 1407-1418.
4.	Sanz M, Marco Del Castillo A, Jepsen S, et al. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol, 2020, 47(3): 268-288.
5.	Marruganti C, Suvan JE, D'Aiuto F. Periodontitis and metabolic diseases (diabetes and obesity): Tackling multimorbidity. Periodontol 2000, 2023.
6.	Prince Y, Davison GM, Davids SFG, et al. The relationship between the oral microbiota and metabolic syndrome. Biomedicines, 2022, 11(1): 3.
7.	Stankevic E, Kern T, Borisevich D, et al. Genome-wide association study identifies host genetic variants influencing oral microbiota diversity and metabolic health. Sci Rep, 2024, 14(1): 14738.
8.	Stein JM, Kuch B, Conrads G, et al. Clinical periodontal and microbiologic parameters in patients with acute myocardial infarction. J Periodontol, 2009, 80(10): 1581-1589.
9.	Joshi C, Bapat R, Anderson W, et al. Detection of periodontal microorganisms in coronary atheromatous plaque specimens of myocardial infarction patients: a systematic review and meta-analysis. Trends Cardiovasc Med, 2021, 31(1): 69-82.
10.	Emdin CA, Khera AV, Kathiresan S. Mendelian Randomization. JAMA, 2017, 318(19): 1925-1926.
11.	Lyu X, Xu X, Shen S, et al. Genetics causal analysis of oral microbiome on type 2 diabetes in East Asian populations: a bidirectional two-sample Mendelian randomized study. Front Endocrinol (Lausanne), 2024, 15: 1452999.
12.	Liu X, Tong X, Zhu J, et al. Metagenome-genome-wide association studies reveal human genetic impact on the oral microbiome. Cell Discov, 2021, 7(1): 117.
13.	Sakaue S, Kanai M, Tanigawa Y, et al. A cross-population atlas of genetic associations for 220 human phenotypes. Nat Genet, 2021, 53(10): 1415-1424.
14.	Sanna S, van Zuydam NR, Mahajan A, et al. Causal relationships among the gut microbiome, short-chain fatty acids and metabolic diseases. Nat Genet, 2019, 51(4): 600-605.
15.	Hartwig FP, Davey Smith G, Bowden J. Robust inference in summary data Mendelian randomization via the zero modal pleiotropy assumption. Int J Epidemiol, 2017, 46(6): 1985-1998.
16.	Bowden J, Davey Smith G, Haycock PC, et al. Consistent estimation in mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol, 2016, 40(4): 304-314.
17.	Ma Z, Zhao M, Zhao H, et al. Causal role of immune cells in generalized anxiety disorder: Mendelian randomization study. Front Immunol, 2024, 14: 1338083.
18.	Toya T, Corban MT, Marrietta E, et al. Coronary artery disease is associated with an altered gut microbiome composition. PLoS One, 2020, 15(1): e0227147.
19.	Han Y, Gong Z, Sun G, et al. Dysbiosis of gut microbiota in patients with acute myocardial infarction. Front Microbiol, 2021, 12: 680101.
20.	Song T, Guan X, Wang X, et al. Dynamic modulation of gut microbiota improves post-myocardial infarct tissue repair in rats via butyric acid-mediated histone deacetylase inhibition. Faseb J, 2021, 35(3): e21385.
21.	Barbour A, Elebyary O, Fine N, et al. Metabolites of the oral microbiome: important mediators of multikingdom interactions. FEMS Microbiol Rev, 2022, 46(1): fuab039.
22.	Nyvad B, Takahashi N. Integrated hypothesis of dental caries and periodontal diseases. J Oral Microbiol, 2020, 12(1): 1710953.
23.	Jin Z, Cao Y, Wen Q, et al. Dapagliflozin ameliorates diabetes-induced spermatogenic dysfunction by modulating the adenosine metabolism along the gut microbiota-testis axis. Sci Rep, 2024, 14(1): 641.
24.	Mo Z, Zhan M, Yang X, et al. Fermented dietary fiber from soy sauce residue exerts antidiabetic effects through regulating the PI3K/AKT signaling pathway and gut microbiota-SCFAs-GPRs axis in type 2 diabetic mellitus mice. Int J Biol Macromol, 2024, 270(Pt 2): 132251.
25.	Hosgood HD, Cai Q, Hua X, et al. Variation in oral microbiome is associated with future risk of lung cancer among never-smokers. Thorax, 2021, 76(3): 256-263.
26.	Li Y, Qian F, Cheng X, et al. Dysbiosis of oral microbiota and metabolite profiles associated with type 2 diabetes mellitus. Microbiol Spectr, 2023, 11(1): e0379622.
27.	Sardu C, Consiglia Trotta M, Santella B, et al. Microbiota thrombus colonization may influence athero-thrombosis in hyperglycemic patients with ST segment elevation myocardialinfarction (STEMI). Marianella study. Diabetes Res Clin Pract, 2021, 173: 108670.
28.	Péan N, Le Lay A, Brial F, et al. Dominant gut Prevotella copri in gastrectomised non-obese diabetic Goto-Kakizaki rats improves glucose homeostasis through enhanced FXR signalling. Diabetologia, 2020, 63(6): 1223-1235.
29.	Wang L, Liang C, Song X, et al. Canagliflozin alters the gut, oral, and ocular surface microbiota of patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne), 2023, 14: 1256292.
30.	Verbrugghe P, Brynjólfsson J, Jing X, et al. Evaluation of hypoglycemic effect, safety and immunomodulation of Prevotella copri in mice. Sci Rep, 2021, 11(1): 21279.
31.	Yavorov-Dayliev D, Milagro FI, Ayo J, et al. Glucose-lowering effects of a synbiotic combination containing Pediococcus acidilactici in C. elegans and mice. Diabetologia, 2023, 66(11): 2117-2138.
32.	Yang Q, Xu Y, Shen L, et al. Guanxinning tablet attenuates coronary atherosclerosis via regulating the gut microbiota and their metabolites in Tibetan minipigs induced by a high-fat diet. J Immunol Res, 2022, 2022: 7128230.
33.	Letchumanan G, Abdullah N, Marlini M, et al. Gut microbiota composition in prediabetes and newly diagnosed type 2 diabetes: a systematic review of observational studies. Front Cell Infect Microbiol, 2022, 12: 943427.
34.	Chen B, Wang Z, Wang J, et al. The oral microbiome profile and biomarker in Chinese type 2 diabetes mellitus patients. Endocrine, 2020, 68(3): 564-572.
35.	Kwun JS, Kang SH, Lee HJ, et al. Comparison of thrombus, gut, and oral microbiomes in Korean patients with ST-elevation myocardial infarction: a case-control study. Exp Mol Med, 2020, 52(12): 2069-2079.
36.	Chen R, Ye Y, Ding Y, et al. Potential biomarkers of acute myocardial infarction based on the composition of the blood microbiome. Clin Chim Acta, 2024, 556: 117843.
37.	Vieira Lima CP, Grisi DC, Guimarães MDCM, et al. Enrichment of sulphate-reducers and depletion of butyrate-producers may be hyperglycaemia signatures in the diabetic oral microbiome. J Oral Microbiol, 2022, 14(1): 2082727.
38.	Mera V, López T, Serralta J. Take traveller's diarrhoea to heart. Travel Med Infect Dis, 2007, 5(3): 202-203.
39.	Clark WF, Sontrop JM, Macnab JJ, et al. Long term risk for hypertension, renal impairment, and cardiovascular disease after gastroenteritis from drinking water contaminated with Escherichia coli O157: H7: a prospective cohort study. BMJ, 2010, 341: c6020.
40.	Cui J, Cui H, Yang M, et al. Tongue coating microbiome as a potential biomarker for gastritis including precancerous cascade. Protein Cell, 2019, 10(7): 496-509.
41.	Lu H, Ren Z, Li A, et al. Tongue coating microbiome data distinguish patients with pancreatic head cancer from healthy controls. J Oral Microbiol, 2019, 11(1): 1563409.
42.	Wang L, Gao Z, Zhao Z, et al. Oral microbiota in periodontitis patients with and without type 2 diabetes mellitus and their shifts after the nonsurgical periodontal therapy. Heliyon, 2023, 9(11): e22110.
43.	Zeng X, Huang S, Ye X, et al. Impact of HbA1c control and type 2 diabetes mellitus exposure on the oral microbiome profile in the elderly population. J Oral Microbiol, 2024, 16(1): 2345942.
44.	Li H, Li C. Causal relationship between gut microbiota and type 2 diabetes: a two-sample Mendelian randomization study. Front Microbiol, 2023, 14: 1184734.
45.	Kunath BJ, Hickl O, Queirós P, et al. Alterations of oral microbiota and impact on the gut microbiome in type 1 diabetes mellitus revealed by integrated multi-omic analyses. Microbiome, 2022, 10(1): 243.
46.	Sharma N, Bhatia S, Sodhi AS, et al. Oral microbiome and health. AIMS Microbiol, 2018, 4(1): 42-66.
47.	Rosier BT, Takahashi N, Zaura E, et al. The importance of nitrate reduction for oral health. J Dent Res, 2022, 101(8): 887-897.
48.	Bahadoran Z, Mirmiran P, Carlström M, et al. Inorganic nitrate: a potential prebiotic for oral microbiota dysbiosis associated with type 2 diabetes. Nitric Oxide, 2021, 116: 38-46.
49.	Borgnakke WS, Ylöstalo PV, Taylor GW, et al. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol, 2013, 84(4 Suppl): S135-S152.
50.	Schenkein HA, Papapanou PN, Genco R, et al. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000, 2020, 83(1): 90-106.
51.	Kerrigan SW, Douglas I, Wray A, et al. A role for glycoprotein Ib in Streptococcus sanguis-induced platelet aggregation. Blood, 2002, 100(2): 509-516.
52.	Lucchese A. Streptococcus mutans antigen Ⅰ/Ⅱ and autoimmunity in cardiovascular diseases. Autoimmun Rev, 2017, 16(5): 456-460.
53.	Yang R, Jia Q, Mehmood S, et al. Genistein ameliorates inflammation and insulin resistance through mediation of gut microbiota composition in type 2 diabetic mice. Eur J Nutr, 2021, 60(4): 2155-2168.
54.	Yang C, Wu J, Yang L, et al. Altered gut microbial profile accompanied by abnormal short chain fatty acid metabolism exacerbates nonalcoholic fatty liver disease progression. Sci Rep, 2024, 14(1): 22385.
55.	Down S, Alzaid A, Polonsky WH, et al. Physician experiences when discussing the need for additional oral medication with type 2 diabetes patients: Insights from the cross-national IntroDia® study. Diabetes Res Clin Pract, 2019, 148: 179-188.
56.	Li Y, Liu Y, Cui J, et al. Oral-gut microbial transmission promotes diabetic coronary heart disease. Cardiovasc Diabetol, 2024, 23(1): 123.

1. Roth GA, Johnson C, Abajobir A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol, 2017, 70(1): 1-25.
2. Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics-2019 update: a report from the american heart association. Circulation, 2019, 139(10): e56-e528.
3. Rawshani A, Rawshani A, Franzén S, et al. Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med, 2017, 376(15): 1407-1418.
4. Sanz M, Marco Del Castillo A, Jepsen S, et al. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol, 2020, 47(3): 268-288.
5. Marruganti C, Suvan JE, D'Aiuto F. Periodontitis and metabolic diseases (diabetes and obesity): Tackling multimorbidity. Periodontol 2000, 2023.
6. Prince Y, Davison GM, Davids SFG, et al. The relationship between the oral microbiota and metabolic syndrome. Biomedicines, 2022, 11(1): 3.
7. Stankevic E, Kern T, Borisevich D, et al. Genome-wide association study identifies host genetic variants influencing oral microbiota diversity and metabolic health. Sci Rep, 2024, 14(1): 14738.
8. Stein JM, Kuch B, Conrads G, et al. Clinical periodontal and microbiologic parameters in patients with acute myocardial infarction. J Periodontol, 2009, 80(10): 1581-1589.
9. Joshi C, Bapat R, Anderson W, et al. Detection of periodontal microorganisms in coronary atheromatous plaque specimens of myocardial infarction patients: a systematic review and meta-analysis. Trends Cardiovasc Med, 2021, 31(1): 69-82.
10. Emdin CA, Khera AV, Kathiresan S. Mendelian Randomization. JAMA, 2017, 318(19): 1925-1926.
11. Lyu X, Xu X, Shen S, et al. Genetics causal analysis of oral microbiome on type 2 diabetes in East Asian populations: a bidirectional two-sample Mendelian randomized study. Front Endocrinol (Lausanne), 2024, 15: 1452999.
12. Liu X, Tong X, Zhu J, et al. Metagenome-genome-wide association studies reveal human genetic impact on the oral microbiome. Cell Discov, 2021, 7(1): 117.
13. Sakaue S, Kanai M, Tanigawa Y, et al. A cross-population atlas of genetic associations for 220 human phenotypes. Nat Genet, 2021, 53(10): 1415-1424.
14. Sanna S, van Zuydam NR, Mahajan A, et al. Causal relationships among the gut microbiome, short-chain fatty acids and metabolic diseases. Nat Genet, 2019, 51(4): 600-605.
15. Hartwig FP, Davey Smith G, Bowden J. Robust inference in summary data Mendelian randomization via the zero modal pleiotropy assumption. Int J Epidemiol, 2017, 46(6): 1985-1998.
16. Bowden J, Davey Smith G, Haycock PC, et al. Consistent estimation in mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol, 2016, 40(4): 304-314.
17. Ma Z, Zhao M, Zhao H, et al. Causal role of immune cells in generalized anxiety disorder: Mendelian randomization study. Front Immunol, 2024, 14: 1338083.
18. Toya T, Corban MT, Marrietta E, et al. Coronary artery disease is associated with an altered gut microbiome composition. PLoS One, 2020, 15(1): e0227147.
19. Han Y, Gong Z, Sun G, et al. Dysbiosis of gut microbiota in patients with acute myocardial infarction. Front Microbiol, 2021, 12: 680101.
20. Song T, Guan X, Wang X, et al. Dynamic modulation of gut microbiota improves post-myocardial infarct tissue repair in rats via butyric acid-mediated histone deacetylase inhibition. Faseb J, 2021, 35(3): e21385.
21. Barbour A, Elebyary O, Fine N, et al. Metabolites of the oral microbiome: important mediators of multikingdom interactions. FEMS Microbiol Rev, 2022, 46(1): fuab039.
22. Nyvad B, Takahashi N. Integrated hypothesis of dental caries and periodontal diseases. J Oral Microbiol, 2020, 12(1): 1710953.
23. Jin Z, Cao Y, Wen Q, et al. Dapagliflozin ameliorates diabetes-induced spermatogenic dysfunction by modulating the adenosine metabolism along the gut microbiota-testis axis. Sci Rep, 2024, 14(1): 641.
24. Mo Z, Zhan M, Yang X, et al. Fermented dietary fiber from soy sauce residue exerts antidiabetic effects through regulating the PI3K/AKT signaling pathway and gut microbiota-SCFAs-GPRs axis in type 2 diabetic mellitus mice. Int J Biol Macromol, 2024, 270(Pt 2): 132251.
25. Hosgood HD, Cai Q, Hua X, et al. Variation in oral microbiome is associated with future risk of lung cancer among never-smokers. Thorax, 2021, 76(3): 256-263.
26. Li Y, Qian F, Cheng X, et al. Dysbiosis of oral microbiota and metabolite profiles associated with type 2 diabetes mellitus. Microbiol Spectr, 2023, 11(1): e0379622.
27. Sardu C, Consiglia Trotta M, Santella B, et al. Microbiota thrombus colonization may influence athero-thrombosis in hyperglycemic patients with ST segment elevation myocardialinfarction (STEMI). Marianella study. Diabetes Res Clin Pract, 2021, 173: 108670.
28. Péan N, Le Lay A, Brial F, et al. Dominant gut Prevotella copri in gastrectomised non-obese diabetic Goto-Kakizaki rats improves glucose homeostasis through enhanced FXR signalling. Diabetologia, 2020, 63(6): 1223-1235.
29. Wang L, Liang C, Song X, et al. Canagliflozin alters the gut, oral, and ocular surface microbiota of patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne), 2023, 14: 1256292.
30. Verbrugghe P, Brynjólfsson J, Jing X, et al. Evaluation of hypoglycemic effect, safety and immunomodulation of Prevotella copri in mice. Sci Rep, 2021, 11(1): 21279.
31. Yavorov-Dayliev D, Milagro FI, Ayo J, et al. Glucose-lowering effects of a synbiotic combination containing Pediococcus acidilactici in C. elegans and mice. Diabetologia, 2023, 66(11): 2117-2138.
32. Yang Q, Xu Y, Shen L, et al. Guanxinning tablet attenuates coronary atherosclerosis via regulating the gut microbiota and their metabolites in Tibetan minipigs induced by a high-fat diet. J Immunol Res, 2022, 2022: 7128230.
33. Letchumanan G, Abdullah N, Marlini M, et al. Gut microbiota composition in prediabetes and newly diagnosed type 2 diabetes: a systematic review of observational studies. Front Cell Infect Microbiol, 2022, 12: 943427.
34. Chen B, Wang Z, Wang J, et al. The oral microbiome profile and biomarker in Chinese type 2 diabetes mellitus patients. Endocrine, 2020, 68(3): 564-572.
35. Kwun JS, Kang SH, Lee HJ, et al. Comparison of thrombus, gut, and oral microbiomes in Korean patients with ST-elevation myocardial infarction: a case-control study. Exp Mol Med, 2020, 52(12): 2069-2079.
36. Chen R, Ye Y, Ding Y, et al. Potential biomarkers of acute myocardial infarction based on the composition of the blood microbiome. Clin Chim Acta, 2024, 556: 117843.
37. Vieira Lima CP, Grisi DC, Guimarães MDCM, et al. Enrichment of sulphate-reducers and depletion of butyrate-producers may be hyperglycaemia signatures in the diabetic oral microbiome. J Oral Microbiol, 2022, 14(1): 2082727.
38. Mera V, López T, Serralta J. Take traveller's diarrhoea to heart. Travel Med Infect Dis, 2007, 5(3): 202-203.
39. Clark WF, Sontrop JM, Macnab JJ, et al. Long term risk for hypertension, renal impairment, and cardiovascular disease after gastroenteritis from drinking water contaminated with Escherichia coli O157: H7: a prospective cohort study. BMJ, 2010, 341: c6020.
40. Cui J, Cui H, Yang M, et al. Tongue coating microbiome as a potential biomarker for gastritis including precancerous cascade. Protein Cell, 2019, 10(7): 496-509.
41. Lu H, Ren Z, Li A, et al. Tongue coating microbiome data distinguish patients with pancreatic head cancer from healthy controls. J Oral Microbiol, 2019, 11(1): 1563409.
42. Wang L, Gao Z, Zhao Z, et al. Oral microbiota in periodontitis patients with and without type 2 diabetes mellitus and their shifts after the nonsurgical periodontal therapy. Heliyon, 2023, 9(11): e22110.
43. Zeng X, Huang S, Ye X, et al. Impact of HbA1c control and type 2 diabetes mellitus exposure on the oral microbiome profile in the elderly population. J Oral Microbiol, 2024, 16(1): 2345942.
44. Li H, Li C. Causal relationship between gut microbiota and type 2 diabetes: a two-sample Mendelian randomization study. Front Microbiol, 2023, 14: 1184734.
45. Kunath BJ, Hickl O, Queirós P, et al. Alterations of oral microbiota and impact on the gut microbiome in type 1 diabetes mellitus revealed by integrated multi-omic analyses. Microbiome, 2022, 10(1): 243.
46. Sharma N, Bhatia S, Sodhi AS, et al. Oral microbiome and health. AIMS Microbiol, 2018, 4(1): 42-66.
47. Rosier BT, Takahashi N, Zaura E, et al. The importance of nitrate reduction for oral health. J Dent Res, 2022, 101(8): 887-897.
48. Bahadoran Z, Mirmiran P, Carlström M, et al. Inorganic nitrate: a potential prebiotic for oral microbiota dysbiosis associated with type 2 diabetes. Nitric Oxide, 2021, 116: 38-46.
49. Borgnakke WS, Ylöstalo PV, Taylor GW, et al. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol, 2013, 84(4 Suppl): S135-S152.
50. Schenkein HA, Papapanou PN, Genco R, et al. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000, 2020, 83(1): 90-106.
51. Kerrigan SW, Douglas I, Wray A, et al. A role for glycoprotein Ib in Streptococcus sanguis-induced platelet aggregation. Blood, 2002, 100(2): 509-516.
52. Lucchese A. Streptococcus mutans antigen Ⅰ/Ⅱ and autoimmunity in cardiovascular diseases. Autoimmun Rev, 2017, 16(5): 456-460.
53. Yang R, Jia Q, Mehmood S, et al. Genistein ameliorates inflammation and insulin resistance through mediation of gut microbiota composition in type 2 diabetic mice. Eur J Nutr, 2021, 60(4): 2155-2168.
54. Yang C, Wu J, Yang L, et al. Altered gut microbial profile accompanied by abnormal short chain fatty acid metabolism exacerbates nonalcoholic fatty liver disease progression. Sci Rep, 2024, 14(1): 22385.
55. Down S, Alzaid A, Polonsky WH, et al. Physician experiences when discussing the need for additional oral medication with type 2 diabetes patients: Insights from the cross-national IntroDia® study. Diabetes Res Clin Pract, 2019, 148: 179-188.
56. Li Y, Liu Y, Cui J, et al. Oral-gut microbial transmission promotes diabetic coronary heart disease. Cardiovasc Diabetol, 2024, 23(1): 123.

Chinese Journal of Evidence-Based Medicine

Latest ArticlesCausal association of oral microbiome characteristics with type 2 diabetes and myocardial infarction: a Mendelian randomization study

Abstract Full text Figures/Tables Video References Cited by

Format

Content