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Understanding the gut–kidney axis among biopsy-proven diabetic nephropathy, type 2 diabetes mellitus and healthy controls: an analysis of the gut microbiota composition

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Abstract

Aims

Type 2 diabetes mellitus (T2DM) has a rising prevalence and gut microbiota involvement is increasingly recognized. Diabetic nephropathy (DN) is a major complication of T2DM. The aim of the study was to understand the gut–kidney axis by an analysis of gut microbiota composition among biopsy-proven DN, T2DM without kidney disease, and healthy control.

Methods

Fecal samples were collected from 14 DNs, 14 age/gender-matched T2DMs without renal diseases (DM), 14 age and gender-matched healthy controls (HC) and household contacts (HH) of DM group. The microbiota composition was analyzed by 16sRNA microbial profiling approach.

Results

Substantial differences were found in the richness of gut microbiota and the variation of bacteria population in DM compared to HC, and DN compared to DM, respectively. DM could be accurately distinguished from age/gender-matched healthy controls by the variable of genus g_Prevotella_9 (AUC = 0.9), and DN patients could be accurately distinguished from age/gender-matched DM by the variables of two genera (g_Escherichia-Shigella and g_Prevotella_9, AUC = 0.86). The microbiota composition of HH group was close to that of HC group, and was different from DM group. Under the same diet, DM could be more accurately detected by the same genus (g_Prevotella_9, AUC = 0.92).

Conclusion

Gut microbiota composition was explored to be related to the occurrence of biopsy-proven DN from DM. DM could be distinguished from HC by detecting g_Prevotella_9 level in feces, while DN was different from DM by the variables of g_Escherichia-Shigella and g_Prevotella_9, which potentially contributed to the physiopathological diagnosis of DN from DM.

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Funding

The study is supported by National Key Research & Development Program of China (2016YFC1305403), National Natural Science Foundation of China (81700634) and International cooperation project (2016HH0069) funded by Science and Technology Department of Sichuan Province.

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Author notes

  1. Sibei Tao, Lingzhi Li and Ling Li contributed equally to the work.

Authors and Affiliations

  1. Kidney Research Laboratory, Division of Nephrology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China

    Sibei Tao, Lingzhi Li, Ling Li, Qian Ren, Min Shi, Jing Liu, Jing Jiang, Huichao Ma, Zhuo Huang, Zijing Xia, Jing Pan, Tiantian Wei, Yan Wang, Peiyun Li, Tian Lan, Xi Tang, Liang Ma & Ping Fu

  2. Chinese Health Service Management Department, West China Hospital of Sichuan University, Chengdu, 610041, China

    Yuan Liu & Huairong Tang

  3. West China Biomedical Big Data Center, Sichuan University, Chengdu, 610041, China

    Xiaoxi Zeng

  4. Department of Pathology, West China Hospital of Sichuan University, Chengdu, 610041, China

    Song Lei

  5. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing Key Laboratory of Kidney Disease, Beijing, 10000, China

    Liang Ma

Authors
  1. Sibei Tao
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Corresponding authors

Correspondence to Liang Ma or Ping Fu.

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The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was approved by Biomedical Ethics Committee of West China Hospital of Sichuan University (No. 2016-273). All the procedures followed the Declaration of Helsinki principles.

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All participants provided written informed consent before enrolment in the study.

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Tao, S., Li, L., Li, L. et al. Understanding the gut–kidney axis among biopsy-proven diabetic nephropathy, type 2 diabetes mellitus and healthy controls: an analysis of the gut microbiota composition. Acta Diabetol 56, 581–592 (2019). https://doi.org/10.1007/s00592-019-01316-7

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