[Microbiome, diabetes and heart: a novel link?]

Patients with type 2 diabetes suffer from a high cardiovascular risk. The underlying pathomechanisms are not fully understood and treatment options are correspondingly limited. The gut microbiome could be a new important player in cardiometabolic diseases. Dysbiosis of the intestinal flora has been associated with insulin resistance, diabetes mellitus and cardiovascular diseases, such as atherosclerosis and heart failure. The negative cardiovascular effects of type 2 diabetes mellitus could therefore partly be mediated by gut microbiota. This review article discusses specific gut microbiome-associated mechanisms, which are modulated in both type 2 diabetes and cardiovascular diseases. It is presented how intestinal bacteria may contribute to systemic low-grade inflammation. Furthermore, it is shown how the intestinal microbiome as a complex metabolic organ is able to influence the cardiometabolic phenotype via production of bioactive metabolites. Further studies will have to demonstrate whether these mechanisms contribute to the high cardiovascular risk in type 2 diabetes.