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Alterations of Urinary Microbiota in Type 2 Diabetes Mellitus with Hypertension and/or Hyperlipidemia.

ABSTRACT: Evidence shows urine specimens from different women have different populations of bacteria. The co-occurrence of hypertension and hyperlipidemia in those with diabetes may alter the composition of urine and the microenviroment of the bladder in which bacteria live. The aim of this study was to characterize the urinary microbiota in women with type 2 diabetes mellitus only and those with diabetes plus hypertension and/or hyperlipidemia, and to explore whether the composition of the urinary microbiota is affected by fasting blood glucose, blood pressure, and blood lipids. We enrolled 28 individuals with diabetes only, 24 with diabetes plus hypertension, 7 with diabetes plus hyperlipidemia, and 11 with diabetes plus both hypertension and hyperlipidemia. Modified midstream urine collection technique was designed to obtain urine specimens. Bacterial genomic DNA was isolated using magnetic beads and the urinary microbiota was analyzed using the Illumina MiSeq Sequencing System based on the V3-V4 hypervariable regions of the 16S rRNA gene. Among the four cohorts, the diabetes plus hypertension cohort had the highest relative abundance of Proteobacteria. In contrast, the diabetes plus hyperlipidemia cohort had the lowest relative abundance of Proteobacteria. In addition, Escherichia and Gardnerella were not found in the diabetes plus hyperlipidemia cohort but they were found in all of the other cohorts. Cetobacterium was only present in the diabetes plus hypertension cohort. The most abundant bacteria in the diabetes only and diabetes plus hyperlipidemia cohorts was Lactobacillus, while Prevotella was the most abundant bacteria in the diabetes plus hypertension and diabetes plus hypertension and hyperlipidemia cohorts. Moreover, the relative abundance of Lactobacillus was significantly lower in the diabetes plus hypertension cohort than in the diabetes only and diabetes plus hyperlipidemia cohorts. Several bacteria were correlated with the participants' fasting blood glucose, blood pressure, and blood lipids. In conclusion, hypertension and/or hyperlipidemia and other patient factors can affect the composition of the urinary microbiota in those with diabetes. The insights from this study could be used to develop microbiota-based treatment for comorbid conditions, including urinary tract infections, in those with diabetes.

SUBMITTER: Liu F

PROVIDER: S-EPMC5334339 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Alterations of Urinary Microbiota in Type 2 Diabetes Mellitus with Hypertension and/or Hyperlipidemia.

Liu Fengping F Ling Zongxin Z Xiao Yonghong Y Yang Qing Q Wang Baohong B Zheng Li L Jiang Ping P Li Lanjuan L Wang Wei W

Frontiers in physiology 20170303

Evidence shows urine specimens from different women have different populations of bacteria. The co-occurrence of hypertension and hyperlipidemia in those with diabetes may alter the composition of urine and the microenviroment of the bladder in which bacteria live. The aim of this study was to characterize the urinary microbiota in women with type 2 diabetes mellitus only and those with diabetes plus hypertension and/or hyperlipidemia, and to explore whether the composition of the urinary microb ...[more]

PMID: 28316574

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Project description:BackgroundLower urinary tract symptoms (LUTS) is the most common complication of diabetes. However, the underlying pathogenesis of cultured negative LUTS (cn-LUTS) in diabetic patients has not been well understood. Numerous evidence indicates that urinary dysbiosis is related to urologic disorders. We aim to study alterations of the urinary microbiota of cn-LUTS in type 2 diabetes (T2D) patients.MethodsFemale T2D patients and controls were recruited and requested to finish the American Urological Association Symptom Index. Mid-stream urine was collected for culturing and extracting DNA. Microbial diversity and composition were analyzed by targeting to 16S rDNA. Linear discriminant analysis effect size (LEfSe) was carried out to identify significantly different bacteria.Results32 female T2D patients and 26 controls were enrolled. No significant differences in alpha diversity were observed between patients and controls. However, statistically decreased richness (ACE index and Chao 1 index, 85.52(13.75, 204.84) vs. 129.82(63.89, 280.30) and 83.86(11.00, 210.77) vs. 125.19(62.00, 251.77), P = 0.005; Observed Species, 76(10, 175) vs. 98(54, 234), P = 0.011) and decreased species diversity (Shannon index, 1.37(0.04, 3.48) vs. 2.09(0.98, 3.43), P = 0.033; Simpson index, 0.46 (0.06, 0.99) vs. 0.23(0.07, 0.64), P = 0.029) were shown in moderate-to-severe LUTS group and high Hemoglobin A1c group, respectively. A significant difference of beta diversity was found between T2D patients and controls and T2D patients with different severity of cn-LUTS as well as the different level of Hemoglobin A1c. LEfSe revealed that 10 genera (e.g., Escherichia-Shigella and Klebsiella) were increased and 7 genera were decreasing in T2D patients, 3 genera (e.g., Escherichia-Shigella and Campylobacter) were increased and 16 genera (e.g., Prevotella) were reduced in moderate-to-severe LUTS group, 2 genera (Escherichia-Shigella and Lactobacillus) were over-represented and 10 genera (e.g., Prevotella) were under-represented in high Hemoglobin A1c group. Finally, Hemoglobin A1c was found positively correlated with the total score of the American Urological Association Symptom Index (r = 0.509, P = 0.003).ConclusionsUrinary dysbiosis may be related to cn-LUTS in female T2D patients. A better understanding of urinary microbiota in the development and progression of cn-LUTS in female T2D patients was necessary. The severity of cn-LUTS was correlated to hyperglycemia and chronic hyperglycemia might induce or promote cn-LUTS by influencing urinary microbiota.

Project description:BackgroundType 2 diabetes mellitus (T2DM) is a risk factor for acute myocardial infarction (AMI) and a common comorbidity in patients with AMI. T2DM doubles the fatality rate of patients with AMI in the acute phase of AMI and the follow-up period. However, the mechanisms by which T2DM increases the fatality rate remain unknown. This study sought to investigate changes in the gut microbiota of patients with AMI and T2DM (AMIDM) to extend understandings of the relative mechanisms from the aspects of gut microbiota.MethodsPatients were recruited and divided into 2 groups comprising 15 patients with AMIDM and 15 patients with AMI but without T2DM (AMINDM). Their stool samples and clinical information were collected. 16S ribosomal DNA sequencing was used to analyze the structure and composition of the gut microbiota based on the operational taxonomic units.ResultsA significant difference was observed in the gut microbiota β diversity between the 2 groups. At the phylum level, the AMIDM patients showed an increase in the abundance of Firmicutes and a decrease in the abundance of Bacteroidetes compared to the AMINDM patients. At the genus level, the AMIDM patients showed an increase in the abundance of Companilactobacillus, Defluvitaleaceae UCG-011 and UCG-009, and a decrease in the abundance of Phascolarctobacterium and CAG 56 compared to the AMINDM patients. At the species level, the AMIDM patients showed an increase in the abundance of species unclassified NK4A214 group, Bacteroides clarus, Coprococcus comes, unclassified Defluviltaleaceae UCG-011, uncultured rumen bacterium, unclassified CAG 56, Barnesiella intestinihominis, Lachnospiraceae bacterium, Bacteroides nordii, unclassified UCG-009, and the Family XIII AD3011 group compared to the AMINDM patients. The gut microbiota function predictions indicated that the nucleotide metabolism-related pathway was significantly more increase in the patients with AMIDM than those with AMINDM. Additionally, the patients with AMIDM showed an increase in gram-positive bacteria and a decrease in the proportion of gram-negative bacteria. Our correlation analysis results on the gut microbiota and clinical parameters might extend understandings of the progression of AMI.ConclusionsChanges in the gut microbiota composition of patients with AMIDM affect the severity of the metabolic disturbance and may be responsible for poorer clinical outcomes and worse disease progression in patients with AMIDM compared to those with AMINDM.

Project description:BackgroundCardiovascular disease is the most prevalent cause of morbidity and mortality in diabetic patients. Hypertension (HTN) has been confirmed as a major risk factor for cardiovascular disease, which is frequently associated with diabetes mellitus (DM). Therefore, the detection and management of elevated blood pressure (BP) is a critical component of the comprehensive clinical management of diabetics. Since the rates of hypertension in diabetics are lacking in Afghanistan, this study aimed to evaluate the prevalence of elevated blood pressure in type-2 diabetic patients.Materials and methodsThis is a descriptive cross-sectional study, which included 321 type -2 diabetic patients (119 males, 202 females) with a mean age of 53.86 ± 11.54 years who were presented to the Noble OPD center from November 2019 to January 2020.ResultsThe elevated blood pressure was detected in 70.5% of the patients. It was more prevalent in women than men (76.8% and 59.7% respectively). The mean systolic blood pressure was 146.94 ± 23.19 mmHg and mean diastolic blood pressure was 89.61 ± 11.59 mmHg. The mean pulse pressure was 57.32 ± 15.58 mmHg and the mean arterial pressure was 48.98 ± 7.73 mmHg. The mean body weight was 73.09 ± 13.75 Kg. The mean duration of diabetes mellitus was 7.08 ± 5.95 years with the average HbA1c of 9.27 ± 2.41%. The mean body mass index (BMI) of the patients was noted 28.77 ± 5.58 kg/m2.ConclusionThis study showed high prevalence of hypertension in type-2 diabetes patients with a significant difference in the rate of elevated blood pressure between males and females (it was higher in females than males). The systolic blood pressure had a positive correlation with age. However, it was insignificant for diastolic blood pressure. Healthcare providers and other health sector should work in collaboration for designing appropriate preventive strategies targeting the modifiable risk factors associated with hypertension.

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Alterations of Urinary Microbiota in Type 2 Diabetes Mellitus with Hypertension and/or Hyperlipidemia.

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Alterations of Urinary Microbiota in Type 2 Diabetes Mellitus with Hypertension and/or Hyperlipidemia.

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