Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2021; 27(19): 2394-2414
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2394
Gut microbiota dysbiosis in Chinese children with type 1 diabetes mellitus: An observational study
Xia Liu, Yi-Wen Cheng, Li Shao, Shu-Hong Sun, Jian Wu, Qing-Hai Song, Hong-Sheng Zou, Zong-Xin Ling
Xia Liu, Department of Intensive Care Unit, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Yi-Wen Cheng, Jian Wu, Zong-Xin Ling, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Li Shao, Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, Hangzhou 310000, Zhejiang Province, China
Li Shao, Institute of Translational Medicine, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310000, Zhejiang Province, China
Shu-Hong Sun, Department of Laboratory Medicine, Linyi People’s Hospital, Linyi 276000, Shandong Province, China
Qing-Hai Song, Department of Geriatrics, Lishui Second People's Hospital, Lishui 323000, Zhejiang Province, China
Hong-Sheng Zou, Department of Intensive Care Unit, People’s Hospital of Rongcheng, Rongcheng 264300, Shandong Province, China
Author contributions: Ling ZX was the guarantor and designed the study; Liu X, Cheng YW, Shao L, Sun SH, Wu J, Song QH, and Zou HS participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Liu X, Cheng YW, Shao L, and Ling ZX revised the article critically for important intellectual content.
Supported by National Natural Science Foundation of China, No. 31700800, No. 81771724, and No. 81790631; and National S&T Major Project of China, No. 2018YFC2000500.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital, School of Medicine, Zhejiang University (Zhejiang, China).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zong-Xin Ling, PhD, Professor, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. lingzongxin_lzx@163.com
Received: January 23, 2021
Peer-review started: January 23, 2021
First decision: February 10, 2021
Revised: February 17, 2021
Accepted: April 14, 2021
Article in press: April 14, 2021
Published online: May 21, 2021
Abstract
BACKGROUND

Gut microbiota dysbiosis is reportedly actively involved in autoimmune diseases such as type 1 diabetes mellitus (T1DM). However, the alterations in the gut microbiota and their correlation with fasting blood glucose (FBG) in Chinese children with T1DM remain unclear.

AIM

To investigate alterations in the gut microbiota in Chinese children with T1DM and their associations with clinical indicators.

METHODS

Samples from 51 children with T1DM and 47 age-matched and gender-matched healthy controls were obtained, to explore the structural and functional alterations in the fecal microbiota. The V3-V4 regions of the 16S rRNA gene were sequenced on a MiSeq instrument, and the association with FBG were analyzed.

RESULTS

We found that the bacterial diversity was significantly increased in the T1DM-associated fecal microbiota, and changes in the microbial composition were observed at different taxonomic levels. The T1DM-reduced differential taxa, such as Bacteroides vulgatus ATCC8482, Bacteroides ovatus, Bacteroides xylanisolvens, and Flavonifractor plautii, were negatively correlated with FBG, while the T1DM-enriched taxa, such as Blautia, Eubacterium hallii group, Anaerostipes hadrus, and Dorea longicatena, were positively correlated with FBG. Bacteroides vulgatus ATCC8482, Bacteroides ovatus, the Eubacterium hallii group, and Anaerostipes hadrus, either alone or in combination, could be used as noninvasive diagnostic biomarkers to discriminate children with T1DM from healthy controls. In addition, the functional changes in the T1DM-associated fecal microbiota also suggest that these fecal microbes were associated with altered functions and metabolic activities, such as glycan biosynthesis and metabolism and lipid metabolism, which might play vital roles in the pathogenesis and development of T1DM.

CONCLUSION

Our present comprehensive investigation of the T1DM-associated fecal microbiota provides novel insights into the pathogenesis of the disease and sheds light on the diagnosis and treatment of T1DM.

Keywords: Dysbiosis, Fasting blood glucose, Sequencing, Metabolism, Type 1 diabetes mellitus

Core Tip: Alterations in the gut microbiota play vital roles in the development of autoimmune diseases such as type 1 diabetes mellitus (T1DM). Our present study explores the overall structure and composition of the fecal microbiota in Chinese children with T1DM and its association with fasting blood glucose (FBG). We found that the bacterial diversity increased significantly in children with T1DM and that several key functional taxa were correlated with FBG. These key functional bacteria could be used as noninvasive diagnostic biomarkers to discriminate T1DM patients from healthy controls. This comprehensive investigation of the T1DM-associated fecal microbiota provides novel insights into the pathogenesis of T1DM.