CHARACTERISTICS OF THE INTESTINAL MICROBIOME IN STROKE PATIENTS WITH INSULIN RESISTANCE

Abstract

Introduction. Advances have been made in the treatment and prevention of stroke in recent decades, but its burden remains 
high. New targets are needed to improve outcomes. Recent studies highlight the role of the intestinal microbiota in the pathogenesis 
of stroke. Changes in the composition of the microbiota, known as dysbiosis, are associated with risk factors for stroke such as 
obesity, metabolic disorders and atherosclerosis. In acute cerebral ischemia, the intestinal microbiota affects the interactions 
between the intestine and the brain, forming the microbiota- intestine -brain axis. Dysbiosis before a stroke affects its outcomes. 
Clinical studies show that in acute ischemic stroke, dysbiosis is associated with metabolism, inflammation, and functional outcomes. 
Modulation of the microbiota or its metabolites improves conditions associated with the pathogenesis of stroke, including 
inflammation, cardiometabolic diseases, atherosclerosis, and thrombosis. 
Aim: to study the characteristics of the intestinal microbiome in patients with stroke and insulin resistance.  
Materials and methods: observational, analytical, and cross-sectional methods, taxonomic analysis of the intestinal 
microbiota, and NGS sequencing.  
Results. A species analysis of the microbiota in patients with stroke and IR revealed a correlation with lactate-producing 
bacteria Streptococcus, butyrate- and acetate-producing bacteria Bacteroides (dorei, massiliensis, plebeius, tobetsuensis) 
and Dialester invisus, a propionate producer. The presence of such poorly understood predictors of stroke in patients with 
insulin resistance suggests a possible influence of the intestinal microbiota in maintaining inflammation, blood pressure 
formation, and stroke in patients with insulin resistance. The role of bacteria producing acetate, butyrates, and propionates in 
the active fermentation of starches, affecting triglycerides with a subsequent increase in insulin resistance is shown. Host
microbiota interactions involving inflammatory and metabolic pathways appear to play a role in the occurrence of 
cardiovascular diseases. Lactate-, butyrate-, and propionate producing bacteria are of no small importance in the 
pathogenesis of hypertension with IR. 
Conclusions. The obtained results underscore a potential link between dysbiosis associated with stroke and the balance of 
organic acids produced by intestinal bacteria, specifically an inverse relationship between stroke and the levels of acetate and 
butyrate. One contributing factor is intestinal inflammation related to dysbiosis, which helps maintain high blood pressure.