Gut Dysbiosis and Diabetic Nephropathy Progression in Patients with Type 2 Diabetes: A Case-Control Study

Abstract

Objective: Diabetic nephropathy (DN) is a leading cause of end-stage renal disease (ESRD). There is growing evidence that intestinal dysbiosis is associated with various disorders. This study aimed to investigate the associations between the human gut microbiome and the development of DN. Materials and methods: This case-control study was carried out on 75 subjects, both sexes, divided into 3 equal groups (n = 25): Group I consisted of healthy participants; Group II included individuals who had type 2 diabetes (T2D) but no nephropathy; and Group III was identified as having DN based on a urine albumin creatinine ratio of 30 mg/g or above. DNA extraction using PCR amplification and 16S rRNA gene sequencing were used to analyze the fecal microbiota. Results: Twenty-five healthy controls (12 women and 13 men) had a mean age of 45 ± 8.77 years. Of the 25 patients with T2D, 11 were females, 14 were males, and the mean age was 45 ± 6.68 years. The average age of the 25 DN patients (10 females and 15 males) was 45 ± 6.68 years. Urinary albumin creatinine ratios were found to positively correlate with Escherichia-Shigella (r = 0.88, p-value < 0.002) and Alistipes (r = 0.91, p < 0.0001), respectively. A negative association (r = –0.77, p-value < 0.0001) was detected between the [Ruminococcus] torques group and the estimated glomerular filtration rate (eGFR). Conclusions: Unbalanced gut microbiota significantly correlates with clinical markers of renal function, cholesterol, blood albumin, and urine albumin creatinine ratio. (Clin Diabetol 2024; 13, 4: 193–199)