Changes in characteristics of gut microbiota and their correlation with clinical indicators in cirrhosis patients after transjugular intrahepatic portosystemic shunt

To compare the differences in gut microbiota between cirrhosis patients receiving transjugular intrahepatic portosystemic shunt (TIPS) and those not, and explore the relationship between TIPS surgery and gut microbiota in order to provide new ideas for improving the prognosis of cirrhosis patients after TIPS surgery based on gut microbiota.

Those who had received TIPS surgery previously were assigned into the operation group, and those without the surgery served as the control group. Their stool samples were collected for 16S rRNA sequencing, and the correlation between gut microbiota and clinical indicators was analyzed.

There were no significant differences in gender, age, body mass index (BMI), etiology and other baseline data between the 2 groups (P>0.05), but obvious differences were observed in clinical serological indicators between them, including INR, APTT, RBC and PT counts, and HGB, ALP, ALB, total bilirubin (TBIL), and URE levels (P<0.05). No statistical difference in alpha diversity was observed between the operation group and the control group (P>0.05), but beta diversity was obviously different (P<0.01), among which Bacteroides was increased in the operation group (P<0.01)and Bifidobacterium was increased in the control group (P<0.05). The function prediction analysis of gut microbiota showed that the metabolism of D-glutamine and D-glutamate (P<0.05) and biosynthesis with secondary bile acids (P<0.05) were up-regulated in the operation group compared with the control group. Correlation analysis between clinical indicators and flora indicated that TBIL and direct bilirubin (DBIL) were significantly correlated with the metabolic pathways of Bacteroides and Secondary bile acids biosynthesis.

Characteristic changes in gut microbiota are found in cirrhosis patients with and without TIPS surgery. Bacteroides may be involved in the regulation of metabolism of bile acids and thus increase bilirubin level.