Causal effect of gut microbiota and diabetic nephropathy: a Mendelian randomization study

Ganyuan He; Jiayi Chen; Wenke Hao; Wenxue Hu

doi:10.1186/s13098-024-01327-7

Causal effect of gut microbiota and diabetic nephropathy: a Mendelian randomization study

Diabetol Metab Syndr. 2024 Apr 24;16(1):89. doi: 10.1186/s13098-024-01327-7.

Authors

Ganyuan He¹, Jiayi Chen¹, Wenke Hao², Wenxue Hu³

Affiliations

¹ Department of Nephrology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Provincial Geriatrics Institute, Southern Medical University, Guangzhou, China.
² Department of Nephrology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Provincial Geriatrics Institute, Southern Medical University, Guangzhou, China. hwk1964@sina.com.
³ Department of Nephrology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Provincial Geriatrics Institute, Southern Medical University, Guangzhou, China. wuleihu@126.com.

Abstract

Background: The interaction of dysbiosis of gut microbiota (GM) with diabetic nephropathy (DN) drew our attention and a better understanding of GM on DN might provide potential therapeutic approaches. However, the exact causal effect of GM on DN remains unknown.

Methods: We applied two-sample Mendelian Randomization (MR) analysis, including inverse variance weighted (IVW), MR-Egger methods, etc., to screen the significant bacterial taxa based on the GWAS data. Sensitivity analysis was conducted to assess the robustness of MR results. To identify the most critical factor on DN, Mendelian randomization-Bayesian model averaging (MR-BMA) method was utilized. Then, whether the reverse causality existed was verified by reverse MR analysis. Finally, transcriptome MR analysis was performed to investigate the possible mechanism of GM on DN.

Results: At locus-wide significance levels, the results of IVW suggested that order Bacteroidales (odds ratio (OR) = 1.412, 95% confidence interval (CI): 1.025-1.945, P = 0.035), genus Akkermansia (OR = 1.449, 95% CI: 1.120-1.875, P = 0.005), genus Coprococcus 1 (OR = 1.328, 95% CI: 1.066-1.793, P = 0.015), genus Marvinbryantia (OR = 1.353, 95% CI: 1.037-1.777, P = 0.030) and genus Parasutterella (OR = 1.276, 95% CI: 1.022-1.593, P = 0.032) were risk factors for DN. Reversely, genus Eubacterium ventriosum (OR = 0.756, 95% CI: 0.594-0.963, P = 0.023), genus Ruminococcus gauvreauii (OR = 0.663, 95% CI: 0.506-0.870, P = 0.003) and genus Erysipelotrichaceae (UCG003) (OR = 0.801, 95% CI: 0.644-0.997, P = 0.047) were negatively associated with the risk of DN. Among these taxa, genus Ruminococcus gauvreauii played a crucial role in DN. No significant heterogeneity or pleiotropy in the MR result was found. Mapped genes (FDR < 0.05) related to GM had causal effects on DN, while FCGR2B and VNN2 might be potential therapeutic targets.

Conclusions: This work provided new evidence for the causal effect of GM on DN occurrence and potential biomarkers for DN. The significant bacterial taxa in our study provided new insights for the 'gut-kidney' axis, as well as unconventional prevention and treatment strategies for DN.

Keywords: Causality; Diabetic nephropathy; Gut microbiota; Mendelian randomization.

Grants and funding

82270780/the General Program of National Natural Science Foundation of China