Intestinal Microbiota in Patients With Nonalcoholic Fatty Liver Disease
Intestinal Microbiota in Patients With Nonalcoholic Fatty Liver Disease
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DOI：
10.1002/hep.26319
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发表时间：
2013-07-01
期刊：
影响因子：
13.5
通讯作者：
Allard, Johane P.
中科院分区：
文献类型：
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作者：
Mouzaki, Marialena;Comelli, Elena M.;Allard, Johane P.
尽管有证据表明肠道微生物群（IM）参与肥胖的发病机制，但非酒精性脂肪性肝病（NAFLD）患者的IM组成尚未得到很好的表征。这项前瞻性横断面研究旨在确定活检证实的NAFLD（单纯性脂肪变性[SS]或非酒精性脂肪性肝炎[NASH]）成人与作为健康对照（HC）的活体肝脏供体之间IM的差异。纳入50例受试者：11例SS、22例NASH和17例HC。从每位参与者中采集一份粪便样本。使用定量实时聚合酶链反应测量总细菌计数，拟杆菌/普雷沃氏菌（Bacteroides/Prevotella）（本文称为拟杆菌属（Bacteroidetes））、纤细梭菌（Clostridium leptum）、梭菌属（C.粪便中有球孢子菌、双歧杆菌、大肠杆菌和大肠杆菌。收集临床和实验室数据、食物记录和活动日志。与SS和HC相比，NASH患者的拟杆菌百分比（拟杆菌与细菌总数之比）较低（P = 0.006），粪便C较高。SS组与SS组比较，球蚴感染率差异有统计学意义（P = 0.04）。其余微生物无差异。由于体重指数（BMI）和膳食脂肪摄入量在各组之间存在差异（P < 0.05），我们对这些变量进行了线性回归调整。C中的差异。在调整BMI和脂肪摄入量后，球孢子虫不再显著。然而，即使在调整这些变量后，NASH的存在和较低的拟杆菌百分比之间仍然存在显著关联（P = 0.002; 95%置信区间5 - 0.06至-0.02）。结论：NASH的存在与粪便中拟杆菌的百分比之间存在反向和饮食/BMI无关的关联，表明IM可能在NAFLD的发展中起作用。
Despite evidence that the intestinal microbiota (IM) is involved in the pathogenesis of obesity, the IM composition of patients with nonalcoholic fatty liver disease (NAFLD) has not been well characterized. This prospective, cross-sectional study was aimed at identifying differences in IM between adults with biopsy-proven NAFLD (simple steatosis [SS] or nonalcoholic steatohepatitis [NASH]) and living liver donors as healthy controls (HC). Fifty subjects were included: 11 SS, 22 NASH, and 17 HC. One stool sample was collected from each participant. Quantitative real-time polymerase chain reaction was used to measure total bacterial counts, Bacteroides/Prevotella (herein referred to as Bacteroidetes), Clostridium leptum, C. coccoides, bifidobacteria, Escherichia coli and Archaea in stool. Clinical and laboratory data, food records, and activity logs were collected. Patients with NASH had a lower percentage of Bacteroidetes (Bacteroidetes to total bacteria counts) compared to both SS and HC (P = 0.006) and higher fecal C. coccoides compared to those with SS (P = 0.04). There were no differences in the remaining microorganisms. As body mass index (BMI) and dietary fat intake differed between the groups (P < 0.05), we performed linear regression adjusting for these variables. The difference in C. coccoides was no longer significant after adjusting for BMI and fat intake. However, there continued to be a significant association between the presence of NASH and lower percentage Bacteroidetes even after adjusting for these variables (P = 0.002; 95% confidence interval 5 -0.06 to -0.02). Conclusion: There is an inverse and diet-/BMI-independent association between the presence of NASH and percentage Bacteroidetes in the stool, suggesting that the IM may play a role in the development of NAFLD.