Urban Vietnam at the microbiome transition: Co-existing enterotypes reflect the global industrialization patterns

Vietnam's rapid socioeconomic and dietary shift presents a unique opportunity to observe how industrialization impacts the gut microbiome. However, Vietnamese populations are underrepresented in global reference datasets. Researchers examined whether healthy adults in Hanoi possess microbial community compositions corresponding to various stages of industrialization.

Metagenomic data from 183 Hanoi participants, analyzed alongside 629 metagenomic datasets from low to middle income (LMI) and high income (HI) countries, were studied using community clustering and multivariable association analyses. The Vietnamese cohort split into two enterotypes, mirroring the global industrialization gradient.

Enterotype 1 resembled low and middle income country (LMIC) populations, demonstrating higher microbial richness and diversity. Enterotype 2 aligned with high income country (HIC) profiles. Both enterotypes showed similar trajectories in taxonomic composition and functional potential. Diet and lifestyle factors explained some differences between the enterotypes, indicating an association with contemporary exposures rather than causation.

Antibiotic resistance profiles also varied between the enterotypes, hinting at the transition involving antimicrobial exposure functions. This study places urban Vietnam at a microbiome transition, where community states associated with different levels of industrialization coexist within a single population. The Vietnamese reference cohort enhances representation in global metagenomic research and establishes a baseline for tracking how rapid socioeconomic change may alter microbial ecology, metabolic capacity, and antimicrobial resistance.