title: Metabolic effects of eradicating breath methane using antibiotics in prediabetic subjects with obesity.
abstract: OBJECTIVE
  Methanogens colonizing the human gut produce methane and influence host metabolism. This study examined metabolic parameters in methane-producing subjects before and after antibiotic treatment.
  
  
  METHODS
  Eleven prediabetic methane-positive subjects (9F, 2M) with obesity (BMI 35.17 ± 7.71 kg/m(2) ) aged 47 ± 9 years were recruited. Subjects underwent breath testing, symptom questionnaire, oral glucose tolerance test (OGTT), lipid profile, and stool Methanobrevibacter smithii levels, gastric transit, and energy utilization analyses. After a 10-day antibiotic therapy (neomycin 500 mg bid/rifaximin 550 mg tid), all testing was repeated.
  
  
  RESULTS
  Baseline stool M. smithii levels correlated with breath methane (R = 0.7, P = 0.05). Eight subjects (73%) eradicated breath methane and showed reduced stool M. smithii (P = 0.16). After therapy, methane-eradicated subjects showed significant improvements in low-density lipoprotein (LDL) (P = 0.028), total cholesterol (P = 0.01), and insulin levels on OGTT (P = 0.05 at 120 minutes), lower blood glucose levels on OGTT (P = 0.054 at 90 minutes), significant reductions in bloating (P = 0.018) and straining (P = 0.059), and a trend toward lower stool dry weight. No changes were detected in gastric emptying time or energy harvest.
  
  
  CONCLUSIONS
  Breath methane eradication and M. smithii reduction are associated with significant improvements in total cholesterol, LDL, and insulin levels and with lower glucose levels in prediabetic subjects with obesity. The underlying mechanisms require further elucidation.
authors.affiliation: Division of Endocrinology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Ruchi
authors.initials: R
authors.lastname: Mathur
authors.affiliation: GI Motility Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Chua
authors.affiliation: Clinical and Translational Research Center (CTRC), Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Mindy
authors.initials: M
authors.lastname: Mamelak
authors.affiliation: GI Motility Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Morales
authors.affiliation: GI Motility Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Barlow
authors.affiliation: Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Darko
authors.initials: D
authors.lastname: Stefanovski
authors.affiliation: GI Motility Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Stacy
authors.initials: S
authors.lastname: Weitsman
authors.affiliation: GI Motility Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Marsh
authors.affiliation: Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Bergman
authors.affiliation: GI Motility Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Pimentel
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001944:Breath Tests; D016022:Case-Control Studies; D002784:Cholesterol / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008697:Methane / Q000032:analysis*; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D011236:Prediabetic State / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D002784:Cholesterol; D008697:Methane
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