Study On The Correlation Between Changes Of Intestinal Flora And Its Metabolites Short-chain Fatty Acids With CVD In Peritoneal Dialysis Patients

ObjectiveIn this study,high-throughput sequencing and gas chromatography-mass spectrometry(GCMS)were used to analyze and compare the intestinal flora and its metabolites of short-chain fatty acids(SCFAs)between peritoneal dialysis patients(PD)and healthy people.To explore the characteristics of intestinal flora and SCFAs in patients with PD,and explore the correlation between intestinal flora,SCFAs and cardiovascular disease(CVD).MethodsWe collected fecal samples and blood samples from 33 patiens receiving maintenance Peritoneal dialysis and 30 healthy volunteers between March 1st 2018 to April 31 st 2019 in ***.V3V4 hypervariable region of 16 S r DNA has been amplified and sequenced by high-throughput sequencing technologies in fecal samples.All OTUs have been noted and analyzed using QIIME after OUT was classified.All statistical analysis were performed using R Studio analysis software and SPSS statistical software.We used GC-MS to dertermine the concentration of SCFAs in blood samples,such as acetate,propionate,ect.We also collected general information,laboratory indicators and color Doppler ultrasound results of all subjects.The subjects were divided into PD group and NC group.PD group was analyzed by subgroup including PD group with CVD and PD group without CVD.The differences of intestinal flora and SCFAs between the groups were compared.We compared the differences in intestinal flora and SCFAs between groups and analyze the correlation between intestinal flora and SCFAs,SCFAs and various indicators.Meanwhile,we analyzed whether changes in intestinal flora and SCFAs are related to CVD in PD patients.Results(1)Results of intestinal flora: Compared with the NC group,the relative abundance of Fusobacteria was significantly increased,while Firmicutes and Actinobacteria were significantly decreased in PD group at the level of phylum.At the level of family,Bacteroidaceae and Fusobacteriaceae were significantly increased,while Bifidobacteriaceae,Marinifilaceae,Ruminococcaceae were significantly decreased.At the level of genus,there were significantly differences in 27 genera.Results of alpha diversity: Compared with the NC group,shannon index and simpson index were significantly decreased in PD patients.Results of beta diversity: The structure of intestinal flora in PD group and NC group was significantly different,which was measured by principal co-ordinates analysis(PCo A)and non-metric multi-dimensional scaling(NMDS).Results of LEf Se analysis: There were significant differences of dominant bacteria between the two groups.Results of intestinal flora in Subgroups: Compared with PD group without CVD,the relative abundance of Odoribacter,Eggerthella,Hydrogenoanaerobacterium were significantly decreased in PD group with CVD.(2)SCFAs quantitative results: Compared with the NC group,the concentrations of valerate and hexanoate were significantly increased in PD group.Compared with PD group without CVD,the concentrations of hexanoate weas significantly increased in PD group with CVD.Results of correlation analysis: Valerate and hexanoate are positively correlated with Verrucomicrobia,Akkermansiaceae,Akkermansia.And they are negatively related to Fusicatenibacter.The concentrations of valerate was significantly correlated with blood urea nitrogen and left atrial diameter.The concentrations of hexanoate was significantly correlated with serum creatinine,left atrial diameter and left ventricular posterior wall thickness.The result of logistic regression analysis: Hexanoate is a important risk factor associated with cardiovascular disease in peritoneal dialysis patients.ConclusionsThis study has showed t composition and structure of intestinal flora of intestinal flora changed significantly in PD patients.Meanwhile,the concentrations of hexanoate was significantly decreased.According to this study,the change of intestinal flora and hexanoate may be risk factors with cardiovascular disease in peritoneal dialysis patients.