The Profile and Function of Gut Microbiota in Diabetic Nephropathy

Abstract

Introduction: Dysbiosis of gut microbiota impairs the homeostasis of immune and metabolic systems. Although previous studies have revealed the correlation between gut microbiota and various diseases, the function between gut microbiota and diabetic nephropathy (DN) has not been discovered distinctly. In this study, we tried to investigate the profile and function of gut microbiota in DN. Methods: A total of 100 people were enrolled in this study. Twenty were healthy people, 20 were diabetes patients, and 60 were DN patients. The DN patients were divided into three stages including stage III, IV, and V. We conducted taxonomic analyses in different groups. The distributions of phyla, classes, orders, families, and genera in different groups and samples were investigated. We also evaluated the correlations between clinical parameters and gut microbiota in 60 DN patients. Results: The gut microbiota in the healthy group, diabetes group, and DN group had 1764 operational taxonomic units (OTUs) in total. The healthy group had 1034 OTUs, the diabetes group had 899 OTUs, and the DN group had 1602 OTUs. The diversity of gut microbiota in the stage III DN group was smaller than that in the other groups. 24-h urinary protein was positively correlated with Alistipes and Subdoligranulum, cholesterol was positively correlated with Bacteroides and Lachnoclostridium, and estimated glomerular filtration rate was negatively correlated with Ruminococcus torques group. Discussion: The gut microbiota might play an important role in the development and pathogenesis of DN. A change in gut microbiota diversity is correlated with disease progression. Some kinds of gut microbiota including Alistipes, Bacteroides, Subdoligranulum, Lachnoclostridium, and Ruminococcus torques group might be detrimental factors in DN.

Gut Microbiota and Complications of Type-2 Diabetes

“…These changes coupled with increased levels of Akkermansia in the gut may contribute to the effects of metformin on glucose metabolism [ 22 ]. It appears that the metabolic factors associated with chronic low-grade inflammation and oxidative stress, which link gut microbiota dysbiosis and type 2 diabetes, are the same ones that influence the onset and progression of diabetic complications [ 23 , 24 ]. This relationship gives credence to the concept that modulation of the gut microbiota may be a promising strategy in the management of diabetes and associated complications as presented in the following sections.…”

Time‐limited diets and the gut microbiota in cardiometabolic disease

“…[179][180][181] Several studies have shown alterations in gut bacterial abundance in patients with diabetic nephropathy compared to controls, and overall lower bacterial diversity was correlated with disease progression. [182][183][184] In rodents, diabetic nephropathy was associated with altered bacterial communities and microbial metabolites like phenyl sulfate 185,186 and correlated with activation of the renin-angiotensin system. 187,188 Several observational studies have tested the effect of Ramadan fasting on diabetic nephropathy severity, but none of them showed significant changes in renal functions.…”

“…In diabetic patients, poor glycemic control and hypertension can lead to glomerular hyperfiltration, albuminuria, nephrotic proteinuria, and development of end‐stage renal disease 179–181 . Several studies have shown alterations in gut bacterial abundance in patients with diabetic nephropathy compared to controls, and overall lower bacterial diversity was correlated with disease progression 182–184 . In rodents, diabetic nephropathy was associated with altered bacterial communities and microbial metabolites like phenyl sulfate 185,186 and correlated with activation of the renin‐angiotensin system 187,188 .…”

The Urogenital System’s Role in Diseases: A Synopsis

“…Diabetic nephropathy (DN) is a common serious microvascular complication of diabetes mellitus (DM) and is associated with significantly increased morbidity and mortality [ 43 ]. Around one third of DM patients develop DN, which is a leading cause of end-stage renal disease (ESRD) [ 44 ]. Five stages (Stage I to V) of DN exist and are categorized based on glomerular filtration rate (GFR) and albuminuria [ 44 ].…”

“…Around one third of DM patients develop DN, which is a leading cause of end-stage renal disease (ESRD) [ 44 ]. Five stages (Stage I to V) of DN exist and are categorized based on glomerular filtration rate (GFR) and albuminuria [ 44 ]. Most of the time, DN is diagnosed once patients have already progressed to stage III or IV, which is considered irreversible [ 45 ].…”