The prebiotic effects of soluble dietary fiber mixture on renal anemia and the gut microbiota in end-stage renal disease patients on maintenance hemodialysis: a prospective, randomized, placebo-controlled study.
The prebiotic effects of soluble dietary fiber mixture on renal anemia and the gut microbiota in end-stage renal disease patients on maintenance hemodialysis: a prospective, randomized, placebo-controlled study.
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维持性血液透析的终末期肾病患者中，可溶性膳食纤维混合物对肾性贫血和肠道微生物区系的益生作用：一项前瞻性、随机、安慰剂对照研究。
DOI：
10.1186/s12967-022-03812-x
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发表时间：
2022-12-14
影响因子：
7.4
通讯作者：
Wang, Zunsong
中科院分区：
文献类型：
--
作者：
Li, Yang;Han, Min;Song, Jia;Liu, Shijin;Wang, Yongjun;Su, Xinhuan;Wei, Kai;Xu, Zhen;Li, Hui;Wang, Zunsong
关键词：
肾性贫血是由终末期肾病（ESRD）引起的，但病因复杂。膳食纤维（DF）用于调节肠道菌群已在某些疾病中显示出有效的治疗效果，但其在肾性贫血中的作用尚不清楚。本研究旨在探讨DF通过调节肠道菌群及其代谢产物短链脂肪酸（SCFAs）对肾性贫血的影响。共纳入162例ESRD患者，随机分为DF组和对照组（口服DF或马铃薯淀粉，10 g/d，持续8周）。分析干预前后患者血红蛋白（Hb）、血清铁（Fe 2+）、血清铁蛋白（SF）、可溶性转铁蛋白受体（sTfR）、铁调素及重组人促红细胞生成素（rhEPO）用量。分别通过16 S rDNA测序和气相色谱-质谱法分析两组的肠道菌群和SCFAs。采用斯皮尔曼相关性检验分析肠道菌群、SCFAs与血液学指标的相关性。与对照组相比，DF组患者Hb [117.0（12.5）g/L vs. 94.0（14.5）g/L，p < 0.001]，Fe 2 + [13.23（4.83）μmol/L vs. 10.26（5.55）μmol/L，p < 0.001]和SF水平[54.15（86.66）ng/ml vs. 41.48（36.60）ng/ml，p = 0.003]。(2)DF组的rhEPO剂量没有显著降低（p = 0.12）。(3)DF组双歧杆菌、乳酸杆菌和乳酸杆菌科菌增加，乳酸杆菌和乳酸杆菌科菌与Hb呈正相关（r = 0.44，p < 0.001; r = 0.44，p < 0.001）和Fe 2+水平（r = 0.26，p = 0.016; r = 0.26，p = 0.016），与rhEPO剂量呈负相关（r =-0.45，p < 0.001; r =-0.45，p < 0.001）。(4)DF组患者血清丁酸（BA）水平升高[0.80（1.65）vs. 0.05（0.04），p < 0.001]，BA水平与Hb呈正相关（r = 0.26，p = 0.019）和Fe 2+（r = 0.31，p = 0.005），并与rhEPO剂量呈负相关（r =-0.36，p = 0.001）。乳酸杆菌和乳酸杆菌科与BA水平呈正相关（r = 0.78，p < 0.001; r = 0.78，p < 0.001）。DF可通过调节肠道菌群和SCFAs改善ESRD患者的肾性贫血。试验注册本研究于2018年12月20日在中国临床试验注册中心（www.chictr.org.cn）注册（ChiCTR 1800020232）。在线版本包含补充材料，可通过10.1186/s12967-022-03812-x获得。
Renal anemia is caused by end-stage renal disease (ESRD) but has a complex etiology. The application of dietary fiber (DF) to regulate the gut microbiota has shown effective therapeutic effects in some diseases, but its role in renal anemia is not clear. The aim of this study was to explore the effect of DF on renal anemia by regulating the gut microbiota and its metabolite, short-chain fatty acids (SCFAs). A total of 162 ESRD patients were enrolled and randomly distributed into a DF or a control group (received oral DF or potato starch, 10 g/day for 8 weeks). Hemoglobin (Hb), serum iron (Fe2+), serum ferritin (SF), soluble transferrin receptor (sTfR), hepcidin and the dosage of recombinant human erythropoietin (rhEPO) before and after intervention in patients were analyzed. The gut microbiota and SCFAs in both groups were analyzed by 16S rDNA sequencing and gas chromatography–mass spectrometry, respectively. Spearman’s correlation test was used to analyze the correlation between the gut microbiota, SCFAs and the hematological indicators. Compared with the control group, (1) the patients in the DF group had higher Hb [117.0 (12.5) g/L vs. 94.0 (14.5) g/L, p < 0.001], Fe2+ [13.23 (4.83) μmol/L vs. 10.26 (5.55) μmol/L, p < 0.001], and SF levels [54.15 (86.66) ng/ml vs. 41.48 (36.60) ng/ml, p = 0.003]. (2) The rhEPO dosage in the DF group was not significantly decreased (p = 0.12). (3) Bifidobacterium adolescentis, Lactobacillus and Lactobacillaceae were increased in the DF group, and Lactobacillus and Lactobacillaceae were positively correlated with Hb (r = 0.44, p < 0.001; r = 0.44, p < 0.001) and Fe2+ levels (r = 0.26, p = 0.016; r = 0.26, p = 0.016) and negatively correlated with rhEPO dosage (r = − 0.45, p < 0.001; r = − 0.45, p < 0.001). (4) Patients in the DF group had elevated serum butyric acid (BA) levels [0.80 (1.65) vs. 0.05 (0.04), p < 0.001] and BA levels were positively correlated with Hb (r = 0.26, p = 0.019) and Fe2+ (r = 0.31, p = 0.005) and negatively correlated with rhEPO dosage (r = − 0.36, p = 0.001). Lactobacillus and Lactobacillaceae were positively correlated with BA levels (r = 0.78, p < 0.001; r = 0.78, p < 0.001). DF may improve renal anemia in ESRD patients by regulating the gut microbiota and SCFAs. Trial registration This study was registered in the China Clinical Trial Registry (www.chictr.org.cn) on December 20, 2018 (ChiCTR1800020232). The online version contains supplementary material available at 10.1186/s12967-022-03812-x.
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影响因子：
24.5
作者：
Paganini, Daniela;Uyoga, Mary A.;Zimmermann, Michael B.
通讯作者：
Zimmermann, Michael B.
DOI：
10.2215/cjn.05240515
发表时间：
2016-02-01
影响因子：
9.8
作者：
Rossi, Megan;Johnson, David W.;Campbell, Katrina L.
通讯作者：
Campbell, Katrina L.
影响因子：
7.1
作者：
Paganini, Daniela;Uyoga, Mary A.;Zimmermann, Michael B.
通讯作者：
Zimmermann, Michael B.
影响因子：
12.2
作者：
Prochazkova P;Roubalova R;Dvorak J;Kreisinger J;Hill M;Tlaskalova-Hogenova H;Tomasova P;Pelantova H;Cermakova M;Kuzma M;Bulant J;Bilej M;Smitka K;Lambertova A;Holanova P;Papezova H
通讯作者：
Papezova H
影响因子：
30.3
作者：
Lancaster, Samuel M.;Lee-McMullen, Brittany;Abbott, Charles Wilbur;Quijada, Jeniffer V.;Hornburg, Daniel;Park, Heyjun;Perelman, Dalia;Peterson, Dylan J.;Tang, Michael;Robinson, Aaron;Ahadi, Sara;Contrepois, Kevin;Hung, Chia-Jui;Ashland, Melanie;McLaughlin, Tracey;Boonyanit, Anna;Horning, Aaron;Sonnenburg, Justin L.;Snyder, Michael P.
通讯作者：
Snyder, Michael P.