Analysis Of Gut Microbial Diversity In Patients Of Type 2 Diabetes With Diabetic Kidney Disease

Objective:To investigate the diversity of gut microbial in patients of type 2 diabetes with diabetic kidney disease(T2DM with DKD).Methods:The general data and clinical test results of 9 patients of type 2 diabetes with diabetic kidney disease(DKD group),9 patients with newly diagnosed type 2 diabetes mellitus(T2DM group)and 8 healthy volunteers(Control group)were collected.Fresh fecal samples were collected,16 s RNAs of bacteria were extracted and amplified,and sequenced by Illumina Mi Seq platform.According to the results of 16 s RNA gene detection,the operable taxonomic unit(OTU)was classified and the classification results were identified.The Partial least squares discriminant analysis(PLS-DA),Alpha diversity analysis and taxonomic composition analysis were carried out by partial least square discriminant analysis.Results:(1)Compared with Control group,Patelet-lymphocyte ratio(PLR)in T2 DM group,and the difference was statistically significant(P<0.05).Diastolic blood pressure,urea and uric acid in DKD group were significantly increased,and there are statistical differences(P<0.05).There were increase in the levels of cystatin C,creatinine and PLR,and the difference was statistically significant(P<0.01).There was increase in fasting blood glucose between T2 DM group and DKD group,and the difference was statistically significant(P<0.05).Compared with T2 DM group,the values of PLR,cystatin C in DKD group were significantly increased,and the difference was statistically significant(P<0.05),and the values of urea,uric acid and creatinine were increased,and the difference was statistically significant(P<0.01),and the correlation analysis showed that cystatin C,urea,creatinine were positively correlated with PLR.(2)Compared with the Control group,the Chao1 index and the ACE index decreased in T2 DM group and the DKD group,and the latter was lower,the Simpson index and the Shannon index decreased in DM group(T2DM with DKD group),although the difference was not significant.(3)Actinobacteria of type 2 diabetes group(T2DM group and DKD group)was significantly higher than the normal control group,and the difference was statistically significant(P<0.05).Although the difference was not significant,compared with the Control group,the ratio of the DKD group was lower.(4)At the level of the genus,compared with the Control group,the T2 DM group and the DKD group were lower in Alloprevotella,and there are statistical differences(P<0.05);Megasphaera was lower in the Control group,and there are statistical differences(P<0.05);In the DKD group,although the difference was not statistically significant,Blautia and Coprococcus was lower compare with Control group;Compare to the T2 DM group,Blautia was lower in the DKD group,in the DKD group,Escherichia and Enterococcus were higher than the Control group,Conclusion: The richness and diversity of gut microbia decrease in patients of type 2diabetes with diabetic kidney disease.The imbalance of gut microbial may be involved in the occurrence and development of type 2 diabetes with diabetic kidney disease.Chronic inflammation may be relate to the occurrence and development of type 2 diabetes with diabetic kidney disease.