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血液透析患者肠道微生物群与血管钙化的关系。

Relationship between gut microbiota and vascular calcification in hemodialysis patients.

机构信息

Department of Nephrology, Peking University Third Hospital, Beijing, PR China.

Department of Nephrology, Xuanwu Hospital Capital Medical University, Beijing, PR China.

出版信息

Ren Fail. 2023 Dec;45(1):2148538. doi: 10.1080/0886022X.2022.2148538.

DOI:10.1080/0886022X.2022.2148538
PMID:36632746
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9848239/
Abstract

INTRODUCTION: Vascular calcification (VC) is an independent risk factor for cardiovascular mortality in end-stage renal disease (ESRD) patients. The pathogenesis of VC is complicated and unclear. Uremic toxins produced by gut microbiota can promote VC. This study aims to identify the differences in gut microbiota between the different VC groups and the main bacteria associated with VC in hemodialysis (HD) patients in an attempt to open up new preventive and therapeutic approaches and define the probable mechanism for VC in HD patients in the future. METHODS: A total of 73 maintenance HD patients were enrolled in this cross-sectional study. According to the abdominal aortic calcification (AAC) scores, the participants were divided into the high AAC score group and the low AAC score group. High-throughput sequencing of the gut microbiota was performed and the results were evaluated by alpha diversity, beta diversity, species correlation, and model predictive analyses. RESULTS: The prevalence of VC was 54.79% (40/73) in the study. The majority of phyla in the two groups were the same, including , , , and . The microbial diversity in the high AAC score group had a decreasing trend ( = 0.050), and the species abundance was significantly lower ( = 0.044) than that in the low AAC score group. The HD patients with high AAC scores showed an increased abundance of and decreased abundances of and at the phylum level; increased abundances of and and decreased abundances of and at the genus level (0.05). and were positively correlated with VC, and , and were negatively correlated with VC. had the greatest influence on VC in HD patients, followed by and CONCLUSIONS: Our results provide clinical evidence that there was a difference in gut microbiota between the different VC groups in HD patients. a lipopolysaccharide (LPS)-producing bacterium, was positively correlated with VC and had the greatest influence on VC. a short-chain fatty acid (SCFA)-producing bacterium, was negatively correlated with VC and had the second strongest influence on VC in HD patients. The underlying mechanism is worth studying. These findings hint at a new therapeutic target.

摘要

简介：血管钙化（VC）是终末期肾病（ESRD）患者心血管死亡率的独立危险因素。VC 的发病机制复杂且尚不清楚。肠道微生物产生的尿毒症毒素可促进 VC。本研究旨在确定不同 VC 组之间肠道微生物群的差异，以及与血液透析（HD）患者 VC 相关的主要细菌，以期为今后 HD 患者的 VC 开辟新的预防和治疗方法，并确定可能的机制。

方法：本横断面研究共纳入 73 例维持性 HD 患者。根据腹主动脉钙化（AAC）评分，将患者分为高 AAC 评分组和低 AAC 评分组。对肠道微生物群进行高通量测序，并通过 alpha 多样性、beta 多样性、物种相关性和模型预测分析进行评估。

结果：研究中 VC 的患病率为 54.79%（40/73）。两组主要菌群相同，包括 、 、 、 。高 AAC 评分组的微生物多样性呈下降趋势（ = 0.050），且物种丰度明显低于低 AAC 评分组（ = 0.044）。高 AAC 评分的 HD 患者在门水平上表现出 增加， 和 减少；在属水平上表现出 增加， 和 减少，而 和 减少（0.05）。和 与 VC 呈正相关，而 、 、 和 与 VC 呈负相关。对 HD 患者 VC 影响最大的是 ，其次是 和

结论：我们的研究结果提供了临床证据，表明 HD 患者不同 VC 组之间的肠道微生物群存在差异。是一种产生脂多糖（LPS）的细菌，与 VC 呈正相关，对 VC 的影响最大。是一种产生短链脂肪酸（SCFA）的细菌，与 VC 呈负相关，对 HD 患者 VC 的影响仅次于 。其潜在机制值得研究。这些发现暗示了一个新的治疗靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/f7c1ec27b89b/IRNF_A_2148538_F0007_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/e758a456e9c7/IRNF_A_2148538_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/f4fc306cc09f/IRNF_A_2148538_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/abae790ad4a1/IRNF_A_2148538_F0003_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/e24b42c7cb97/IRNF_A_2148538_F0004_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/4dd922b14525/IRNF_A_2148538_F0005_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/a31768a15db7/IRNF_A_2148538_F0006_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/f7c1ec27b89b/IRNF_A_2148538_F0007_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/e758a456e9c7/IRNF_A_2148538_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/f4fc306cc09f/IRNF_A_2148538_F0002_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/abae790ad4a1/IRNF_A_2148538_F0003_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/e24b42c7cb97/IRNF_A_2148538_F0004_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/4dd922b14525/IRNF_A_2148538_F0005_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/a31768a15db7/IRNF_A_2148538_F0006_C.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96fb/9848239/f7c1ec27b89b/IRNF_A_2148538_F0007_B.jpg

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本文引用的文献

[1]
Vascular Calcification and the Gut and Blood Microbiome in Chronic Kidney Disease Patients on Peritoneal Dialysis: A Pilot Study.

Biomolecules. 2022-6-21

[2]
Uremic Toxin-Producing Species Prevail in the Gut Microbiota of Taiwanese CKD Patients: An Analysis Using the New Taiwan Microbiome Baseline.

Front Cell Infect Microbiol. 2022

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Correlation between intestinal flora disruption and protein-energy wasting in patients with end-stage renal disease.

BMC Nephrol. 2022-4-4

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Diet Quality and Protein-Bound Uraemic Toxins: Investigation of Novel Risk Factors and the Role of Microbiome in Chronic Kidney Disease.

J Ren Nutr. 2022-9

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Interplay between gut microbiota, bone health and vascular calcification in chronic kidney disease.

Eur J Clin Invest. 2021-9

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The Effects of Hemodialysis and Peritoneal Dialysis on the Gut Microbiota of End-Stage Renal Disease Patients, and the Relationship Between Gut Microbiota and Patient Prognoses.

Front Cell Infect Microbiol. 2021-3-23

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Compositional change of gut microbiome and osteocalcin expressing endothelial progenitor cells in patients with coronary artery disease.

PLoS One. 2021

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Gut Microbes. 2021

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Tzu Chi Med J. 2020-7-29

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A comparative study of acarbose, vildagliptin and saxagliptin intended for better efficacy and safety on type 2 diabetes mellitus treatment.

Life Sci. 2021-6-1

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