Gut dysbiosis is associated with poorer long-term prognosis in cirrhosis

Table 1 Comparison of the gut microbiome at different taxonomic levels between the groups

Taxa	Heath controls (n = 21)	Cirrhosis with non-severe dysbiosis (n = 24)	Cirrhosis with severe dysbiosis (n = 24)	P value, Non-severe dysbiosis vs controls	P value, Severe dysbiosis vs controls	P value, Severe dysbiosis vs non-severe one
Firmicutes	91.8 (89.3-96.4)	89.7 (73.0-93.6)	80.1 (62.7-88.1)	0.074	< 0.001	0.028
Clostridia	88.0 (86.6-91.7)	83.5 (69.8-88.7)	69.8 (57.4-77.2)	0.008	< 0.001	0.001
Ruminococcaceae	33.9 (28.1-41.6)	27.6 (19.2-36.5)	18.8 (7.9-31.7)	0.086	0.002	0.081
Lachnospiraceae	43.8 (37.2-54.6)	37.6 (27.2-60.5)	31.0 (22.1-46.0)	0.488	0.030	0.190
Bacilli	0.1 (0.0-0.2)	0.5 (0.2-1.9)	7.1 (1.3-14.8)	< 0.001	< 0.001	< 0.001
Streptococcaceae	0.03 (0.02-0.10)	0.29 (0.12-0.52)	3.20 (0.38-10.4)	< 0.001	< 0.001	0.002
Lactobacillaceae	0.00 (0.00-0.01)	0.02 (0.01-0.22)	0.47 (0.12-1.50)	0.002	< 0.001	< 0.001
Enterococcaceae	0.00 (0.00-0.00)	0.00 (0.00-0.03)	0.03 (0.01-0.08)	0.067	0.001	< 0.001
Bacteroidetes	5.6 (2.8-8.1)	5.7 (1.8-12.9)	6.1 (3.2-8.2)	0.954	0.829	0.959
Bacteroidaceae	2.5 (0.8-3.4)	1.3 (0.6-4.3)	1.4 (0.2-3.8)	0.991	0.432	0.261
Actinobacteria	0.2 (0.1-0.3)	0.8 (0.3-2.8)	0.7 (0.4-2.9)	< 0.001	< 0.001	0.687
Bifidobacteriaceae	0.1 (0.0-0.2)	0.6 (0.1-2.6)	0.5 (0.2-2.3)	0.002	0.001	0.687
Proteobacteria	0.39 (0.14-0.51)	0.15 (0.10-0.81)	3.57 (1.77-6.65)	0.869	< 0.001	< 0.001
Enterobacteriaceae	0.03 (0.01-0.05)	0.04 (0.02-0.61)	2.70 (1.58-6.24)	0.104	< 0.001	< 0.001

Table 2 Main indicators of patients with cirrhosis with severe and non-severe dysbiosis

	Severe dysbiosis (n = 24)	Non-severe dysbiosis (n = 24)	P value
Age, yr	51.5 (42.0-59.0)	50.0 (35.0-57.5)	0.392
Body mass index, kg/m2	24.6 (22.8-27.7)	24.2 (22.7-27.7)	0.837
Male/female	12/12	11/13	0.500
Etiology of cirrhosis: Alcohol	9	9	0.617
Autoimmune	2	7	0.068
HBV	7	2	0.068
HCV	5	3	0.350
Cryptogenic	1	3	0.304
Child–Turcotte–Pugh score	9 (8-10)	7 (6-9)	0.047
Death	13	3	0.001
Death within the first year of follow-up	5	2	0.092
Death during the following years of follow-up	8	1	0.002
Esophageal varices (present/absent)	20/4	18/6	0.477
Hepatic encephalopathy (overt/minimal/absent)	11/9/4	6/11/7	0.288
Number connection test, seconds	87 (65-118)	79 (59-92)	0.248
Ascites (present/absent)	16/8	11/13	0.122
Spontaneous bacterial peritonitis (present/absent)	0/24	0/24	1.000
Red blood cells, 1012 cell/L	3.8 (3.4-4.0)	3.9 (3.6-4.5)	0.370
White blood cells, 109 cell/L	3.8 (2.7-5.3)	3.8 (3.1-5.2)	0.628
Platelets, 109 cell/L	87 (55-120)	76 (60-108)	0.860
Serum total protein, g/L	70 (61-76)	73 (64-78)	0.599
Serum albumin, g/L	31 (28-37)	38 (34-41)	0.009
Serum total bilirubin, μmol/L	47 (31-62)	31 (24-63)	0.375
Prothrombin index (Quick test), %	58 (48-67)	64 (54-71)	0.239
Creatinine, mg/dL	0.69 (0.53-0.87)	0.73 (0.66-0.90)	0.187
Serum sodium, mmol/L	141 (139-144)	141 (138-143)	0.795
Serum potassium, mmol/L	4.3 (4.0-4.7)	4.3 (4.1-4.7)	0.844
Serum glucose, mmol/L	5.1 (4.7-5.6)	5.3 (4.7-6.0)	0.260
Alanine aminotransferase, U/L	36 (25-72)	37 (23-60)	0.804
Aspartate aminotransferase, U/L	54 (41-98)	40 (26-67)	0.219
Gamma glutamyl transferase, U/L	77 (40-148)	76 (36-131)	0.621
Alkaline phosphatase, U/L	221 (188-340)	222 (166-298)	0.542
Cholinesterase, kU/L	2.7 (1.9-3.7)	4.0 (3.6-4.5)	0.031
C-reactive protein, mg/L	10.1 (2.1-16.1)	2.1 (0.3-8.9)	0.032
Splenic length, cm	15.4 (14.0-17.6)	16.1 (13.3-19.2)	0.841

HBV: Hepatitis B virus; HCV: Hepatitis C virus.