The Characteristics Of Gut Microbiota Of Type 2 Diabetes Mellitus In NAFLD Patients

Backgrounds: Non-alcoholic fatty liver disease(NAFLD)is the most common cause of liver injury worldwide.NAFLD is considered as a concentrated manifestation of metabolic syndrome in liver,and often companies with obesity,diabetes mellitus,hyperlipidemia and other components of metabolic syndrome.There is a significant increase in the incidence of severe liver disease events in NAFLD patients with type 2 diabetes mellitus than those without type 2 diabetes mellitus.Aims: Through investigating the gut microbial composition changes in healthy people,NALFD patients without type 2 diabetes mellitus,and NAFLD patients with type 2 diabetes mellitus,we aim to explore novel microbial biomarkers of NAFLD,and microbial changes responsible for increased incidence of severe liver disease events in NAFLD patients with type 2 diabetes mellitus.Methods: 31 NAFLD patients were enrolled in the investigation,of which 12 patients were complicated with type 2 diabetes mellitus.17 healthy volunteers were enrolled as control.Intestinal microbiota composition was analyzed by 16 S DNA gene sequencing.Fecal microbial diversity and composition were compared.Results: In this study,alpha diversity,beta diversity,ANOSIM similarity and LEfSe analysis were used to analyze the diversity of intestinal flora in NAFLD patients with/without type 2 diabetes mellitus and healthy control.Compared to control group,Richness of gut microbiota in NALFD patients was decreased.The relative abundances of Allisonella,Escherichia-Shigella,Megasphaera,Collinsella,Terrisporobacter were significantly higher in NALFD patients,while the relative abundances of Prevotella,Mogibacterium,Pseudomonas,Oscillospira,Epulopiscium,Victivallis,Mailhella,Lactococcus,Fournierella,Roseburia,Lachnospira were signiciantly lower in NALFD patients.At family level,relative abundances of Coriobacteriaceae,Veillonellaceae and Enterobacteriaceae were significantly higher,while Muribaculaceae,Defluviitaleaceae,Christensenellaceae,Eubacteriaceae,Pseudomonadaceae,Erysipelotrichaceae and Peptococcaceae were signicantly lower in NALFD patients.When NAFLD patients were divided into 2 groups according to the presence or absence of type 2 diabetes mellitus,both subgroup of NAFLD were with lower diversity than the control group.NAFLD with type 2 diabetes mellitus had higher relative abundance of Allisonella,Megasphaera,Porphyromonas and Porphyromonadaceae than control group and NAFLD patients without type 2 diabetes mellitus.Conclusion: The gut microbiota in NALFD are altered,with lower richness and different constitution.When accompanied with type 2 diabetes mellitus,NAFLD show greater differences in gut microbial constitution.These microbial changes might be risk factors and predictors of severe hepatic events in NAFLD patients with type 2 diabetes mellitus.