Altered bacterial community composition is associated with the development of hepatogenous diabetes in patients with liver cirrhosis

Purpose The purpose of this study was to investigate the association of gut microbiota with hepatogenous diabetes (HD) in patients with cirrhosis. Methods The composition and diversity of the gut microbiota were detected via 16S rRNA gene sequencing in 80 cirrhotic patients. An oral glucose tolerance test (OGTT) was performed to evaluate glucose disturbances. The associations of gut microbiota with impaired glucose tolerance (IGT) and HD were analyzed. Results Among the 80 cirrhotic patients, 21 patients had normal glucose tolerance (NGT), 26 patients had IGT, and 33 patients had HD. The Firmicutes/Bacteroidetes ratios in patients with IGT and HD (2.225 and 2.232, respectively) were lower than those in patients with NGT (3.286). At the genus level, patients with HD had a significantly lower richness of Faecalibacterium, Clostridium, Gemmiger and Roseburia and a significantly greater richness of Lactobacillus and Enterococcus than did those with NGT ( P  < 0.05). Patients with HD also had significantly lower abundances of Clostridium, Faecalibacterium, Gemiger and Lactobacillus than did those with IGT ( P  < 0.05). Furthermore, the LEfSe analysis revealed that patients with HD were enriched for Enterococcus and Enterobacteriaceae . Conclusion In patients with liver cirrhosis, seriously altered bacterial community composition, characterized by decreased richness of short-chain fatty acids-producing bacteria and increased richness of Enterococcus and Enterobacteriaceae , was associated with the development of HD. These finding unveil a novel mechanistic insight into HD pathogenesis and suggest targeting the modulation of gut microbiota may offer a promising strategy in the management of HD.