Cardiovascular disease risk factors in women with O-desmethylangolensin producing and non-producing gut microbial metabotypes: an observational study

BACKGROUND: Daidzein, an isoflavone in soy, is metabolized to O-desmethylangolensin (ODMA) by select gut bacteria. Not all individuals have gut microbiomes capable of producing ODMA, resulting in ODMA producer and non-producer metabotypes. A limited body of research suggests that ODMA producers have lower systolic blood pressure, percent body fat and total cholesterol, compared to non-producers. More work is needed to confirm this relationship in other populations. METHODS: Data from the Study of Women's Health Across the Nation (SWAN), a study of women in their middle years, was used. A subset of women who reported consumption of isoflavones in diet or supplements was included for this analysis. Urinary ODMA and daidzein of 148 participants were measured via HPLC-MS-MS to classify metabotypes: ODMA (nmol/L)/daidzein (nmol/L) = 0, non-producers (n = 23); ODMA (nmol/L)/daidzein (nmol/L) > 0 but less than 0.5, low-producers (n = 90); and ODMA (nmol/L)/daidzein (nmol/L) > 0.5, high-producers (n = 35). Multivariable linear regression models were used to compare cardiovascular disease (CVD) risk markers among groups. Models were adjusted for age, race, self-reported health, blood pressure medication, smoking, menopausal status and anthropometry. RESULTS: ODMA non-producers had higher systolic blood pressure (adj. mean difference = 7.6 mmHg, 95% CI: 1.1, 14.1, p = 0.02) compared to high producers. Another trend but not statistically significant difference observed included higher fasting serum glucose (adj. mean difference = 6.1 mg/dl, CI: -0.9, 13.2, p = 0.09) in ODMA non-producers when compared to ODMA producers. CONCLUSIONS: In this diverse sample of U.S. women, this study observed higher blood pressure in ODMA non-producers than ODMA producers. This aligns with prior work associating ODMA producers with a more favorable CVD risk profile compared to non-producers, and provides additional evidence that this gut microbial metabotype may be related to cardiovascular health.