Dyslipidemia is a common condition in the general population, which considerably increases cardiovascular risks. Treating it is essential, and modulating the intestinal microbiota may soon find its place in doctors’ therapeutic arsenal.
Almost 40% of adults affected
Dyslipidemia—hypercholesterolemia, hypertriglyceridemia, and mixed dyslipidemia—is a major risk factor for atherosclerosis and its resulting cardiovascular complications1. According to the WHO, total cholesterol ≥ 5.0 mmol/l is found in 40% of the world’s population; it is believed to cause one-third of all myocardial ischemia events and around 4.5% of all deaths worldwide2.
Multiple risk factors and the intestinal microbiota are involved
It is now widely acknowledged that the intestinal microbiota is involved in its host’s metabolism and that both genetic and environmental factors (medications, unhealthy lifestyle, etc.) can affect its composition. Certain bacterial groups act on lipid metabolism3 by producing molecules that impact cholesterol transportation, hepatic lipid metabolism, energetic expense, and insulin sensitivity. The connection between imbalances in the microbiota and dyslipidemia was confirmed in mice, where susceptibility to atherosclerosis was transmitted from an obese animal to a healthy animal via fecal transplant3.
Treatment for dyslipidemia is based on lifestyle and dietary changes and the prescription of hypolipidemic drugs such as statins. Furthermore, modifying the intestinal microbiota represents a promising option4,5. Studies in mice have shown that administering the bacteria Akkermansia muciniphila to an obese animal significantly improves its lipid profile6. In humans, the presence of this bacteria has also been associated with better metabolic health (reduction in total and LDL- cholesterol) following a low-calorie diet6,7.
1. HAS, Février 2017. Principales dyslipidémies : stratégies de prise en charge
2. OMS, Raised cholesterol http://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/
3. Gregory JC et al. Transmission of atherosclerosis susceptibility with gut microbial transplantation. J. Biol. Chem. 2015;290:5647–5660
4. Chen D et al. The effect of Lactobacillus rhamnosus hsryfm 1301 on the intestinal microbiota of a hyperlipidemic rat model. BMC Complement Altern Med. 2014 Oct 10;14:386https://www.ncbi.nlm.nih.gov/pubmed/25300818
5. Martínez I et al. Diet-induced metabolic improvements in a hamster model of hypercholesterolemia are strongly linked to alterations of the gut microbiota. Appl Environ Microbiol. 2009 ;75:4175-84.
6. Dao MC, Everard A, Aron-Wisnewsky J, et al. Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome rich- ness and ecology. Gut 2016 ; 65 : 426-36.
7. Org E et al. Genetic and environmental control of host-gut microbiota interactions. Genome Res. 2015;25:1558–1569.