Evidence map›Paper›PMID 42799756›Full record

ArticleGut microbes2026

Plasma indole-3-propionic acid is a gut-derived metabolite and is associated with type 2 diabetes and cardiometabolic outcomes: Evidence from a human antibiotic intervention.

Florine H M Westerbeke, Moritz V Warmbrunn, Melany Rios-Morales, Xinmin S Li, Melissa Y Tian, Madelyn A Novak, Austin M Williams, Stanley L Hazen, Ilias Attaye, Max Nieuwdorp

Abstract read
In one paragraph

Article in Gut microbes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Florine H M WesterbekeDepartment of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.ORCID 0009-0007-1860-7520
Moritz V WarmbrunnDepartment of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.ORCID 0000-0003-3548-6728
Melany Rios-MoralesDepartment of Experimental Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.ORCID 0000-0002-3028-7562
Xinmin S LiDepartment of Heart, Blood, and Kidney Research, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0003-4946-4271
Melissa Y TianDepartment of Heart, Blood, and Kidney Research, Cleveland Clinic, Cleveland, OH, USA.
Madelyn A NovakDepartment of Heart, Blood, and Kidney Research, Cleveland Clinic, Cleveland, OH, USA.
Austin M WilliamsDepartment of Heart, Blood, and Kidney Research, Cleveland Clinic, Cleveland, OH, USA.
Stanley L HazenDepartment of Heart, Blood, and Kidney Research, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0001-7124-6639
Ilias AttayeDepartment of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.
Max NieuwdorpDepartment of Internal and Vascular Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.ORCID 0000-0002-1926-7659

Funding

Project 3: Microbiota generated aryl sulfates and secondary bile acids in cardiometabolic diseaseP01HL147823 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI Stanley L Hazen · 2019 to 2026
$17.0M
Gut Flora Metabolism of Dietary Phosphatidylcholine and CVDR01HL103866 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI HAZEN, STANLEY L · 2010 to 2023
$10.8M
NHLBI NIH HHS P01 HL147823NHLBI NIH HHS R01 HL103866
6 · The paper itself

Abstract

The gut microbiota influences host metabolism through diverse metabolites, many of which have been linked to glucose homeostasis and type 2 diabetes (T2D). Understanding microbial contributions to metabolite biosynthesis is essential for developing dietary and microbiota-targeted T2D prevention and treatment strategies. We performed targeted plasma metabolomics in individuals with T2D and healthy controls, all receiving histidine supplementation, before and after gut microbiota suppression using 7-day broad-spectrum antibiotic treatment. Associations between pre-antibiotic metabolite levels and fecal metagenomics-derived gut microbiota composition were examined using co-abundance network analysis and Random Forest modeling. Indole-3-propionic acid (IPA) was the only gut-derived metabolite differing between groups before antibiotics, with lower levels in T2D and higher levels associated with reduced T2D odds. Antibiotic treatment reduced IPA to near-undetectable levels in both groups, confirming its predominantly microbial origin. Beyond established inverse associations with BMI and glycemic markers, we found a novel inverse correlation between IPA and glycemic variability, consistent with a protective association with T2D. Plasma IPA was associated with gut microbiota beta diversity. IPA-associated species clustered within a single co-abundance module, but did not include known IPA producers, suggesting plasma IPA is influenced by broader microbial community composition rather than IPA-producing capacity of individual taxa alone. This study provides direct human evidence that plasma IPA is virtually exclusively gut microbiota-derived in individuals with T2D, extending prior findings in healthy populations. It highlights IPA's relevance to metabolic health and T2D, and guides future research on dietary and microbiota-targeted strategies to modulate IPA, advancing T2D prevention and treatment.

Indexed as

Anti-Bacterial AgentsDiabetes Mellitus, Type 2Gastrointestinal MicrobiomeIndolesAdultBacteriaFecesFemaleHumansMaleMiddle AgedPropionates3-(indol-3-yl)propionic acidAnti-Bacterial Agentsindolepropionic acidIndolesPropionatesantibioticgut microbiotaIndole-3-propionic acidIPAmetabolitetype 2 diabetes

Identifiers

PMID42799756
PMCPMC13618833

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.