肠道菌群演替在慢性肾病早期诊断及肠-肾轴干预中的价值OA

Objective To analyze the metabolic characteristics of the gut microbiota in patients with dif-ferent stages of CKD,and to screen microbial markers related to disease progression through 16S rRNA gene sequencing.Methods A total of 148 subjects who visited the Nephrology Department of Beijing Chaoyang Hospital,Capital Medical University from November 2022 to October 2023 were included,including 54 healthy controls(HC group),67 patients with CKD stage 1(GFR-NOR group),and 27 patients with CKD stages 2-3(GFR-DIS group).The structure and function of the gut microbiota were analyzed through 16S rRNA gene sequencing.Results At the phylum level,the abundance of Fusobacteri gradually increased in the HC group,GFR-NOR group,and GFR-DIS group,while the abundances of Chloroflexi,Actinobacteria,etc.gradually de-creased.The average relative abundance of the Bacteroidetes phylum in the GFR-NOR group(8.26%)and the GFR-DIS group(10.40%)was higher than that in the HC group(7.94%);the average relative abundance of the Actinobacteria phylum in the GFR-NOR group(19.34%)and the GFR-DIS group(18.62%)was low-er than that in the HC group(23.71%).Compared with the HC group,the α diversity of the gut microbiota in the GFR-NOR group and the GFR-DIS group decreased,and the Shannon index and Goods_coverage index showed statistically significant differences among the three groups(P<0.05).In the gut microbiota β diversi-ty among the three groups,there were statistically significant differences in the distribution on the first axis in both PCA and PCoA between the HC group and the GFR-NOR group,and between the HC group and the GFR-DIS group(P<0.05).The abundance of Enterobacteriaceae was negatively correlated with eGFR(P<0.05),and positively correlated with systolic blood pressure,diastolic blood pressure,LDL-C,serum creati-nine,and blood glucose(P<0.05);the abundance of Klebsiella was negatively correlated with systolic blood pressure,diastolic blood pressure,LDL-C,serum creatinine,and blood glucose(P<0.05),and positively cor-related with HDL-C(P<0.05).Conclusion In the early stage of CKD,there is already a specific dysbiosis of the gut microbiota.The gut microbiota may serve as a new target for the diagnosis and treatment of CKD.