Fecal Microbiota Transplantation (FMT) & Metabolic Syndrome (MetS)

Preclinical data

In the context of Fecal Microbiota Transplantation (FMT) & Metabolic Syndrome (MetS), experimental data suggest treating obesity and other disorders associated with metabolic syndrome with Fecal Microbiota Transplantation (FMT) (1)

Systematic reviews and meta-analyses

A meta-analysis including nine studies, comprising 303 participants revealed that Fecal Microbiota Transplantation (FMT) does not produce any serious adverse effects and may be beneficial as an adjunctive therapy in the treatment of metabolic syndrome, especially in improving blood glucose, increasing insulin sensitivity, and HDL cholesterol. However, due to the small number of relevant studies and the low quality of evidence, we need more high-quality studies on the role of FMT in the metabolic processes of glucose and lipids. Moreover, the fact that the FMT application is associated with changes in obesity-related parameters needs further confirmation when we include diet and lifestyle changes in the design (5).

Randomized clinical trials (RCTs)

For the randomized clinical phase II treatment trial NCT02050607 - Fecal Microbiota Transplantation (FMT) & Metabolic Syndrome, results are not uniquely traceable in the published record as of January 2026

The randomized clinical phase I/II trial NCT02496390 - Fecal Microbiota Transplantation (FMT) allogenic vs Fecal Microbiota Transplantation (FMT) autologous & Non-Alcoholic Fatty Liver Disease (NAFLD) / Metabolic dysfunction-associated fatty liver disease (MAFLD) demonstrated that FMT did not improve insulin resistance, as measured by HOMA-IR or hepatic PDFF. Nonetheless, it indicated a potential to reduce small intestinal permeability in patients with NAFLD (4)

The randomized clinical prevention trial NCT03020186 - DIRECT PLUS - Fecal Microbiota Transplantation (FMT) (autologues, conditioned) & Metabolic syndrome (MetS) revealed that first improve the microbiome with a green, plant-rich, polyphenol-rich diet, then autologous FMT may help maintain some of that benefit during the regain phase (8)

The double-blind, randomized controlled pilot trial NTR 4338 - Fecal Microbiota Transplantation (FMT) (lean vegan-donor) vs Fecal Microbiota Transplantation (FMT) (autologous) & Metabolic syndrome (MetS) revealed that in patients with metabolic syndrome, a single fecal microbiota transplantation from a lean vegan donor led to noticeable alterations in the composition of their gut microbiota. However, this intervention did not succeed in bringing about changes in the production capacity of TMAO or in parameters associated with vascular inflammation (6).

The clinical trial NTR1776 - Fecal Microbiota Transplantation (FMT) allogenic vs Fecal Microbiota Transplantation (FMT) autologous & Metabolic syndrome (MeS) demonstrated significant findings. Six weeks following the infusion of microbiota from lean donors, there was an increase in the insulin sensitivity of the recipients. Specifically, the median rate of glucose disappearance improved from 26.2 to 45.3 µmol/kg/min, with a statistical significance of P < .05. Additionally, there was an increase in the levels of butyrate-producing intestinal microbiota. These results suggest that intestinal microbiota could potentially be developed as therapeutic agents to enhance insulin sensitivity in humans (3)

The randomized clinical trial NTR4327 - Fecal Microbiota Transplantation (FMT) after bariatric surgery vs Fecal Microbiota Transplantation (FMT) before bariatric surgery & Metabolic syndrome (MetS) demonstrated that allogenic Fecal Microbiota Transplantation (FMT) using metabolic syndrome donors (MeTs-D) reduces insulin sensitivity in recipients with metabolic syndrome when compared to using post-roux-en-Y gastric bypass donors (rYgB-D). Additional research is necessary to clarify the impact of donor characteristics on the effectiveness of FMT in individuals with insulin resistance (2)

• XXX - Fecal Microbiota Transplantation (FMT) (allogenic from lean donors) vs Fecal Microbiota Transplantation (FMT) (autologous) & Metabolic syndrome (MetS)

In the randomized clinical trial XXX - Fecal Microbiota Transplantation (FMT) (allogenic from lean donors) vs Fecal Microbiota Transplantation (FMT) (autologous) & Metabolic syndrome (MetS), it was discovered that the positive impact of lean donor fecal microbiota transplantation (FMT) on glucose metabolism is associated with alterations in gut microbiota and plasma metabolites. Furthermore, these effects can be anticipated by examining the initial composition of the fecal microbiota (7).

References:

(1) Marotz & Zarrinpar 2016 Yale J Biol Med. 89: 383–388
(2) De Groot et al. 2019 Gut 69: 502-512
(3) Vrieze et al. 2012 Gastroenterology 143(4): 913-17
(4) Craven et al. 2020 The American Journal of Gastroenterology 115(7): 1055-1065
(5) Qiu et al. 2023 PLoS One 18(7): e0288718
(6) Smits et al. 2018 J Am Heart Assoc 7(7): e008342
(7) Kootte et al. 2017 Cell Metab 26(4): 611-619
(8) Rinott et al. 2021 Gastroenterology 160: 158-173

see also:
Dysbiosis & Metabolic Syndrome (MetS)
Fecal Microbiota Transplantation (FMT) & Adiposity / Obesity
Fecal Microbiota Transplantation (FMT) + Low-fermentable (LF) fibers & Metabolic syndrome (MetS)
Metabolic Syndrome (MetS) & Drugs/Treatments