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Three study visits are planned (at baseline, 15\u2009and 30\u2009months). Baseline measurements include assessment of the stool microbiome and administration of an oral glucose tolerance test, which will yield indexes of insulin sensitivity, insulin secretion and insulin clearance. The gut microbiome profile (composition and function) will be determined using whole metagenome shotgun sequencing along with analyses of plasma short chain fatty acids. Additional data collected include dietary history, sociodemographic factors, health habits, anthropometry, medical history, medications and family history. Most assessments are repeated 15 and 30\u2009months following baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After screening 875 individuals, 129 African American and 224 non\u2010Hispanic white participants were enrolled. At baseline, African American participants have higher blood pressure, weight, body mass index, waist and hip circumferences but similar waist\u2010hip ratio compared with the non\u2010Hispanic white participants. On average, African American participants are less insulin\u2010sensitive and have higher acute insulin secretion and lower insulin clearance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The longitudinal design and robust characterization of potential mediators will allow for the assessment of glucose and insulin homeostasis and gut microbiota as they change over time, improving our ability to discern causal relationships between the microbiome and the insulin homeostasis traits whose deterioration determines T2D, setting the stage for future microbiome\u2010directed therapies to prevent and treat T2D.<\/jats:p>\n                  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Population Sciences, The Lundquist Institute for Biomedical Innovation and Harbor\u2010UCLA Medical Center  Torrance California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lok\u2010Sze Kelvin","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation and Harbor\u2010UCLA Medical Center  Torrance California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Roll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation and Harbor\u2010UCLA Medical Center  Torrance California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Sandow","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation and Harbor\u2010UCLA Medical Center  Torrance California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Biology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen S.","family":"Rich","sequence":"additional","affiliation":[{"name":"Center for Public Health Genomics University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome I.","family":"Rotter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation and Harbor\u2010UCLA Medical Center  Torrance California 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