Long Jianhua, Feng Zhimin, Zhou Huidong, Liu Jia, Zhang Jianglei, Ouyang Jun
From the Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Exp Clin Transplant. 2023 Apr;21(4):350-360. doi: 10.6002/ect.2022.0366.
The incidence of diabetes significantly increases after kidney transplant, and the associated gut microbiota are closely related to diabetes. However, the gut microbiota of recipients with diabetes after kidney transplant remain unexplored.
Feces samples from recipients with diabetes 3 months after kidney transplant were collected and analyzed using high-throughput 16S rRNA gene sequencing.
Our study included 45 transplant recipients: 23 posttransplant diabetes mellitus recipients, 11 recipients without diabetes mellitus, and 11 recipients with preexisting diabetes mellitus. No significant differences in intestinal flora richness and α diversity were observed among the 3 groups. However, principal coordinate analysis based on UniFrac distance revealed significant differences in β diversity. At the phyla level, the abundance of Proteobacteria in posttransplant diabetes mellitus recipients decreased (P = .028), whereas that of Bactericide (P = .004) increased. At the class level, the abundance of Gammaproteobacteria (P = .037) decreased, whereas thatofBacteroidia (P=.004)increased.Attheorderlevel, the abundanceof Enterobacteriales (P = .039)decreased, whereasBacteroidales (P=.004)increased.Atthe family level, the abundance of Enterobacteriaceae (P = .039) and Peptostreptococcaceae (P = .008) decreased, whereas Bacteroidaceae (P = .010) increased. At the genus level,the abundance of Lachnospiraceae incertae sedis (P = .008) decreased, whereas Bacteroides (P = .010) increased. Furthermore, KEGG analysis identified 33 pathways, among which the biosynthesis of unsaturated fatty acids was closely related to gut microbiota and posttransplant diabetes mellitus.
To our knowledge, this is the first comprehensive analysis of the gut microbiota from posttransplant diabetes mellitus recipients. The microbial composition of stool samples of post- transplant diabetes mellitus recipients was significantly different from recipients without diabetes and with preexisting diabetes. The number of bacteria producing short-chain fatty acids decreased, whereas pathogenic bacteria increased.
肾移植后糖尿病的发病率显著增加，且相关的肠道微生物群与糖尿病密切相关。然而，肾移植后糖尿病受者的肠道微生物群仍未得到充分研究。
收集肾移植后3个月糖尿病受者的粪便样本，采用高通量16S rRNA基因测序进行分析。
本研究纳入45例移植受者，其中23例为移植后糖尿病受者，11例无糖尿病受者，11例为移植前已患糖尿病受者。三组之间肠道菌群丰富度和α多样性未观察到显著差异。然而，基于UniFrac距离的主坐标分析显示β多样性存在显著差异。在门水平上，移植后糖尿病受者中变形菌门的丰度降低（P = 0.028），而拟杆菌门的丰度增加（P = 0.004）。在纲水平上，γ-变形菌纲的丰度降低（P = 0.037），而拟杆菌纲的丰度增加（P = 0.004）。在目水平上，肠杆菌目的丰度降低（P = 0.039），而拟杆菌目的丰度增加（P = 0.004）。在科水平上，肠杆菌科（P = 0.039）和消化链球菌科（P = 0.008）的丰度降低，而拟杆菌科（P = 0.010）的丰度增加。在属水平上，未分类的毛螺菌科的丰度降低（P = 0.008），而拟杆菌属的丰度增加（P = 0.010）。此外，KEGG分析确定了33条通路，其中不饱和脂肪酸的生物合成与肠道微生物群和移植后糖尿病密切相关。
据我们所知，这是首次对移植后糖尿病受者的肠道微生物群进行全面分析。移植后糖尿病受者粪便样本的微生物组成与无糖尿病和移植前已患糖尿病的受者有显著差异。产生短链脂肪酸的细菌数量减少，而病原菌数量增加。
