Figure 1.

Identified gut microbiota affect type 2 diabetes development and host serum metabolites. A: Algorithm performance in the discovery cohort and external validation cohort 1 based on the selected microbiome features, host genetics, lifestyle and diet, type 2 diabetes traditional risk factors (FORS, including age, sex, parental history of diabetes, BMI, systolic blood pressure, HDL, triglycerides, and waist circumference), and their combination. B: Association of the MRS with type 2 diabetes risk in the discovery cohort, external validation cohort 1, and external validation cohort 2. Poisson regression was used to estimate the RR and 95% CI of type 2 diabetes per 1-unit change in the MRS, with adjustment for demographic, dietary, and lifestyle factors. C: Association between the MRS and prospective glucose increments over 3 years in the discovery cohort. Linear regression was used to estimate the difference in future fasting glucose per unit change in the MRS in a cohort of 249 individuals without type 2 diabetes, with adjustment for demographic, dietary, and lifestyle factors (model 1). Sensitivity analyses were conducted by adding baseline fasting glucose in the above model 1 to test the influence of baseline fasting glucose on the performance of our model (model 2). D: Association of the MRS with host circulating metabolites. Spearman correlation coefficients between the MRS and the host serum metabolites were calculated. The MRS-metabolite associations were further replicated in the external validation cohort 1. *P < 0.05; #P < 0.01; +P < 0.001.