Gut microbial indicators of metabolic health underlie age-related differences in obesity and diabetes risk among Native Hawaiians and Pacific Islanders

Native Hawaiians and Pacific Islanders (NHPIs) suffer from a higher prevalence of and mortality to type 2 diabetes mellitus (T2DM) than any other major race/ethnic group in Hawaii. In addition, the SARS-CoV-2 pandemic further exacerbated health inequities in this indigenous population. However, there is limited understanding of the role of gut bacteria in the context of inflammation-related diseases of health disparities, including T2DM and obesity. To address these gaps, the study used a community-based research approach from a cohort enriched with NHPI residents on the island of Oahu, Hawaii. Gut microbiome profiling was achieved through metagenomic sequencing analysis from stool DNA. In addition, gut bacterial capacity for butyrate-kinase (BUK)-mediated fiber metabolism was assessed using quantitative PCR to measure the abundance of DNA and RNA relative to the total bacterial load per stool sample. Furthermore, it was observed that overlapping patterns between gut bacteria and T2DM risk factors indicated more nuanced, interdependent interactions among these factors as partial determinants of health outcomes. This study adds to the paucity of NHPI-specific data to further elucidate the biological characteristics associated with pre-existing health inequities in this racial/ethnic group that is significantly underrepresented in biomedical research.