Published online May 27, 2021. doi: 10.4254/wjh.v13.i5.557
Peer-review started: January 16, 2021
First decision: February 24, 2021
Revised: February 28, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 27, 2021
Gut dysbiosis is common in cirrhosis.
The aim is to study the influence of gut dysbiosis on prognosis in cirrhosis.
The objectives include the development and test of a modified dysbiosis ratio (MDR) to distinguish between patients with cirrhosis and healthy controls, patients with compensated and decompensated cirrhosis, deceased and surviving patients.
The case-control study included 48 in-patients with cirrhosis and 21 healthy controls. Stool microbiome was assessed using 16S ribosomal ribonucleic acid gene sequencing. We used MDR: [Bacilli (%) + Proteobacteria (%)]/[Clostridia (%) + bacteroidetes (%)]. Patients with MDR more its median made up the group with severe dysbiosis, others did the group with non-severe dysbiosis. The follow-up period was 4 years.
The mortality rate of patients with severe dysbiosis was significantly higher than that of patients with non-severe dysbiosis. The presence of severe dysbiosis was independent risk factors for death. The deceased patients had a higher MDR value than the survivors. MDR was higher in patients with cirrhosis than in health controls and in patients with decompensated cirrhosis than in patients with compensated cirrhosis.
Gut dysbiosis is associated with a poorer long-term prognosis in cirrhosis.
A larger study involving non-included patient populations should be provided to confirm the findings. New studies are needed to evaluate how various methods (e.g., probiotics, prebiotics, antibiotics, and fecal transplantation) can correct dysbiosis by analyzing the MDR and how this correction can improve the prognosis of patients with cirrhosis.