A systematic review and meta-analysis of gut microbiota in diabetic kidney disease: Comparisons with diabetes mellitus, non-diabetic kidney disease, and healthy individuals

Shisheng Han; Min Chen; Pei Cheng; Zeng Zhang; Yan Lu; Yanqiu Xu; Yi Wang

doi:10.3389/fendo.2022.1018093

A systematic review and meta-analysis of gut microbiota in diabetic kidney disease: Comparisons with diabetes mellitus, non-diabetic kidney disease, and healthy individuals

Front Endocrinol (Lausanne). 2022 Oct 20:13:1018093. doi: 10.3389/fendo.2022.1018093. eCollection 2022.

Authors

Shisheng Han¹, Min Chen¹, Pei Cheng², Zeng Zhang³, Yan Lu¹, Yanqiu Xu¹, Yi Wang¹

Affiliations

¹ Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Department of Hemodialysis, Lin'an Third People's Hospital, Hangzhou, Zhejiang, China.
³ Department of Endocrine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Abstract

Background: Gut microbiota has been reported to play an important role in diabetic kidney disease (DKD), however, the alterations of gut bacteria have not been determined.

Methods: Studies comparing the differences of gut microbiome between patients with DKD and non-DKD individuals using high-throughput sequencing technology, were systematically searched and reviewed. Outcomes were set as gut bacterial diversity, microbial composition, and correlation with clinical parameters of DKD. Qualitative data were summarized and compared through a funnel R script, and quantitative data were estimated by meta-analysis.

Results: A total of 15 studies and 1640 participants were included, the comparisons were conducted between DKD, diabetes mellitus (DM), non-diabetic kidney disease (NDKD), and healthy controls. There were no significant differences of α-diversity between DKD and DM, and between DKD and NDKD, however, significant lower microbial richness was found in DKD compared to healthy controls. Different bacterial compositions were found between DKD and non-DKD subjects. The phylum Actinobacteria were found to be enriched in DKD compared to healthy controls. At the genus level, we found the enrichment of Hungatella, Bilophila, and Escherichia in DKD compared to DM, patients with DKD showed lower abundances of Faecalibacterium compared to those with NDKD. The genera Butyricicoccus, Faecalibacterium, and Lachnospira were depleted in DKD compared to healthy controls, whereas Hungatella, Escherichia, and lactobacillus were significantly enriched. The genus Ruminococcus torques group was demonstrated to be inversely correlated with estimated glomerular filtration rate of DKD.

Conclusions: Gut bacterial alterations was demonstrated in DKD, characterized by the enrichment of the genera Hungatella and Escherichia, and the depletion of butyrate-producing bacteria, which might be associated with the occurrence and development of DKD. Further studies are still needed to validate these findings, due to substantial heterogeneity.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022340870.

Keywords: diabetes mellitus; diabetic kidney disease; gut microbiota; meta-analysis; systematic review.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Bacteria
Diabetes Mellitus*
Diabetic Nephropathies*
Gastrointestinal Microbiome*
Glomerular Filtration Rate
Health Status
Humans