Hydrogen sulfide to modulate Glycated hemoglobin and gut microbiome in type 2 diabetes mellitus.

AIMS: Hydrogen sulfide (H2S) is a gasotransmitter implicated in carbohydrate metabolism. This study explored associations between circulating H2S, glucose homeostasis, and gut microbiome composition in type 2 diabetes mellitus (DM).

METHODS

Blood H2S levels were quantified by HPLC in 93 DM patients; insulin resistance was assessed using HOMA-IR. Gut microbiota from 38 patients were analyzed via Oxford Nanopore 16S rRNA sequencing. Analyses were stratified by median H2S and HbA1c values.

RESULTS

Median H2S and HbA1c levels were 22.65 μM and 7 %, respectively. Patients with H2S ≥ 22.65 μM were more likely to have HbA1c ≥ 7 % (OR: 2.75; 95 % CI: 1.18-6.38; p = 0.022). Higher H2S was linked to lower gut microbial diversity (Shannon index: 3.36 vs. 3.67, p = 0.021; Simpson index: 0.89 vs. 0.93, p = 0.007). Low H2S was associated with higher relative abundance of Actinomycetota (p = 0.022). No microbiome differences were observed when stratified by HbA1c, and diabetes therapy was not linked to microbial diversity.

CONCLUSIONS

Increased blood H2S correlated with higher HbA1c and reduced microbial diversity, including decreased Actinomycetota. H2S may represent a potential marker of poor glycemic control and gut microbiota alteration in DM.