Compositional and functional differences in human gut microbiome with respect to equol production and its association with blood lipid level: a cross-sectional study

Gut microbiota affects lipid metabolism interactively with diet. Equol, a metabolite of isoflavones produced by gut bacteria, may contribute substantially in beneficial lipid-lowering effects. This study aimed to examine equol production-related gut microbiota differences among humans and its consequent association with blood lipid levels.

Characterization of the gut microbiota by deep shotgun sequencing and serum lipid profiles were compared between equol producers and non-producers. Gut microbiota differed significantly at the community level between equol producers and non-producers (P = 0.0062). At the individual level, 32 species associated with equol production were identified. Previously reported equol-producing related species Adlercreutzia equolifaciens and Bifidobacterium bifidum showed relatively higher abundance in this study in equol producers compared to non-producers (77.5% vs. 22.5%; 72.0% vs. 28.0%, respectively). Metabolic pathways also showed significant dissimilarity between equol producers and non-producers (P = 0.001), and seven metabolic pathways were identified to be associated with the equol concentration in urine. Previously reported equol production-related gene sequences in A. equolifaciens 19450T showed higher relative abundance in equol producers than in non-producers. Additionally, we found that equol production was significantly associated with the prevalence of dyslipidemia, including a marginal increase in serum lipids (27.1% vs. 50.0%, P = 0.02). Furthermore, equol production was not determined by intake of soy isoflavones, which suggested that gut microbiota is critical in the equol production process.

Both content and functioning of the microbial gut community significantly differed between equol producers and non-producers. Further, equol producers showed lower prevalences of dyslipidemia, which suggests the important role that equol might play in lipid metabolism by gut microbiota.