Abstract
Type 2 diabetes mellitus (T2DM) may be associated with altered urinary microbiota in female patients. We investigated alterations of urinary microbiota in Chinese female T2DM patients, and explored the associations between urinary microbiota and a patient’s fasting blood glucose (FBG), urine glucose (UGLU), age, menstrual status, and body mass index (BMI). Midstream urine was collected from 70 female T2DM patients and 70 healthy females. Microbial diversity and composition were analyzed using the Illumina MiSeq sequencing platform by targeting the hypervariable V3-V4 regions of the 16S rRNA gene. We found that bacterial diversity was decreased in T2DM patients. Increased Actinobacteria phylum was positively correlated with FBG, UGLU, and BMI; Lactobacillus abundance decreased with age and menopause; and increased Lactobacillus correlated positively with FBG and UGLU. Decreased Akkermansia muciniphila was associated with FBG and UGLU. Escherichia coli abundance did not differ between the two cohorts. Carbohydrate and amino acid metabolism was reduced in T2DM patients, which were associated with bacterial richness indices such as Chao1 and ACE. Detailed microbiota analysis of well-characterized T2DM patients and healthy controls indicate that Chinese T2DM female patients exhibit dysbiosis of urinary microbiota.
Highlights
Type 2 diabetes mellitus (T2DM) accounts for 90% of diabetes [1]
We studied whether the difference in urinary microbiota between healthy controls (HCs) and T2DM patients can be detected, and if these differences are influenced by patients’ conditions, such as fasting blood glucose (FBG), urine glucose (UGLU), body mass index (BMI), etc
Good’s coverage indicated sufficient depth for the investigation of T2DM-associated urinary microbiota (Figure 1A). Both Shannon and Simpson indices illustrated the urinary microbiota diversity was lower in T2DM patients than in HCs (Table 2 and Table S1; Figure 1B and 1C)
Summary
Type 2 diabetes mellitus (T2DM) accounts for 90% of diabetes [1]. T2DM is not due to insufficient use of insulin but due to insufficient insulin secretion and insufficient insulin action. Hospitalization rate for urinary tract infection (UTI) caused by diabetes is over twice as much as those caused by other factors [2]. Damage to the genitourinary system caused by diabetic neuropathy results in bladder dysfunction, and increases the probability of UTI [3]. High levels of urine glucose (UGLU) can favor a proper microenvironment for UTI due to increased bacterial overgrowth [4]. Female patients are known to have higher prevalence of UTI than males [5], which may be associated with the anatomical and structural differences in the urethra between genders
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