The Correlation Analysis Between Intestinal Microbial Diversity And Metabolic Indicators In Patients With End-stage Diabetic Nephropathy In Southern Fujian

Objective:To investigate the characteristics of intestinal microbial diversity in patients with end-stage diabetic nephropathy（DN）in southern Fujian.To analyze the effect of intestinal microbiota on the development of DN,and provide a theoretical basis for the treatment of DN in future by altering intestinal microbiota.Methods:20 patients with end-stage DN（DN group）,24 patients with diabetes（DM group）and 19 healthy volunteers（HC group）who were treated at Xiang ’an Branch of the First Affiliated Hospital of Xiamen University were recruited.Their morning feces were collected and the DNA of intestinal microbiota were extracted from feces.Genes were sequenced by Illumina HiSeq high-throughput sequencing platform and bioinformatics analysis was performed according to the results of 16s rDNA.To compare difference of intestinal microbial diversity among groups,and analyze the correlation between intestinal microbiota and metabolic indexes in DN patients.Results:（1）.At the Phylum taxonomic level,the structure of intestinal microbiota was composed of Firmicutes and Bacteroidetes in DN group,DM group,and HC group.But the ratio of Firmicutes to Bacteroidetes were increased in DN group.（2）.The alpha diversity and beta diversity were significantly diverse among three groups.And they were significantly decreased in DN group.（3）.The abundance of Alistipes,Parabacteroides,and Ruminiclostridium₅ were significantly increased in DN group,but the abundance of Butyricicoccus was significantly decrease.The abundance of Collinsella was significantly increased in DM group.The abundance of Prevotella₉ was significantly increased in HC group.（4）.The metabolic function of infectious diseases was significantly strengthened in DN group.The metabolic function of starch and sucrose metabolism was significantly weakened in DM group.（5）.Alistipes were positively interrelated with the level of serum BUN（P<0.05）.Parabacteroides were negatively interrelated with eGFR（P<0.01）,and were positively related with the level of serum BUN and Scr（P<0.05）.Collinsella were positively correlated with HbAlc and FPG（P<0.001）.Prevotella₉ were positively interrelated with eGFR,and were negatively interrelated with the level of Scr（P<0.001）,and were negatively interrelated with the level of UA,CRP and BUN（P<0.05）.Conclusions:（1）The intestinal microbial diversity decreased significantly in patients with endstage DN in southern Fujian.（2）The variations of special intestinal microbial abundance in patients with end-stage DN in southern Fujian were closely interrelated with metabolic indexes such as eGFR,Scr and BUN,and may be involved in the development of DN.However,the exact interaction mechanisms between intestinal microbiota and DN need further research and discussion.