Alteration of gut microbial profile in patients with diabetic nephropathy.

AIMS

Investigations show that 30-40% of patients with diabetes develop diabetic nephropathy (DN). The gut microbiome has become lively field research in diabetes mellitus and chronic kidney disease. The gut microbial profile in DN (stage-3 or 4) patients and healthy controls were systematically analyzed, the discrepancies on microbial profiles in different disease stages, gender, and BMI in DN were also described.

METHODS

Fecal samples from 37 healthy volunteers (HG) and 43 DN patients (PG) were recruited to gut microbiota 16S rDNA V3-V4 regions analysis. In consideration of disease stage, gender, and BMI, PG, and HG were further divided into three subgroups. To predict the DN stage, a random forest model was carried out, using the most discrepant genera selected from the PG and HG samples.

RESULTS

Gut bacterial richness and diversity in PG were far less than HG. The gut microbiota composition in PG-III was at the middle level between HG and PG-IV. The gender and BMI had some impact on the gut microbiota profile but the major difference still came from the disease. The random forest model was constructed from 25 most discrepant microbe genera. The area under curve (AUC) of receiving operational curve (ROC) was 0.972, indicated a high discriminatory power to predict DN.

CONCLUSIONS

DN patients showed dysbiosis and a decrease in gut bacterial richness and diversity compared with HG. Several characterized genera like Megasphaera, Veillonella, Escherichia-Shigella, Anaerostipes, and Haemophilus might be the new potential microbial biomarkers of DN.