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Cox IJ, Idilman R, Fagan A, Turan D, Ajayi L, Le Guennec AD, Taylor-Robinson SD, Karakaya F, Gavis E, Andrew Atkinson R, Williams R, Sikaroodi M, Nizam S, Gillevet PM, Bajaj JS. Metabolomics and microbial composition increase insight into the impact of dietary differences in cirrhosis. Liver Int 2020; 40:416-427. [PMID: 31544308 PMCID: PMC6980909 DOI: 10.1111/liv.14256] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/04/2019] [Accepted: 09/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Dietary changes can modulate gut microbiota and interact with cirrhosis. Our prior study demonstrated that microbial diversity was higher in cirrhotics from Turkish vs the USA, which was associated with lower risk of 90-day hospitalizations. We aimed to define gut microbial functional and metabolomic changes to increase insight into benefits of the Mediterranean compared to Western diets. METHODS In all, 139 Turkish (46 controls/50 compensated/43 decompensated) and 157 American subjects (48 controls/59 compensated/50 decompensated) were studied. Turkish subjects consumed a modified Mediterranean diet with daily fermented milk intake, whereas Americans consumed a Western diet. Predicted gut microbial functionalities and plasma metabolomics were compared between/within countries. Correlation network differences between microbiota and metabolites in cirrhotics from Turkey vs the USA were evaluated. RESULTS Predicted microbial function showed lower amino acid, bioenergetics and lipid pathways, with functions related to vitamin B, glycan, xenobiotic metabolism, DNA/RNA synthesis, in cirrhotics from Turkey compared to the USA. Plasma metabolomics demonstrated higher relative lactate levels in Turkey vs the USA. The metabolite changes in decompensated cirrhosis, compared to controls, showed similar trends in Turkey and the USA, with reduced lipids and phosphocholines. Phosphocholines were significantly lower in patients hospitalized in 90 days (P = .03). Correlation networks in cirrhotics demonstrated linkage differences between beneficial taxa, Blautia and Oscillispira, and lactate and unsaturated lipids, in Turkey compared to American patients. CONCLUSIONS A modified Mediterranean diet was associated with altered plasma metabolomics and beneficially alters microbiota functionality and correlations compared to Western diet in cirrhosis. These altered diet-microbial interactions could potentially affect the 90-day hospitalization risk.
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Affiliation(s)
- I Jane Cox
- Institute for Hepatology London, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College Hospital, London, UK
| | | | - Andrew Fagan
- Virginia Commonwealth University and McGuire Veterans Affairs Medical Center, Richmond, VA, USA
| | | | - Lola Ajayi
- Institute for Hepatology London, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College Hospital, London, UK
| | - Adrien D Le Guennec
- Randall Centre for Cell & Molecular Biophysics and Centre for Biomolecular Spectroscopy, King's College London, London, UK
| | | | | | - Edith Gavis
- Virginia Commonwealth University and McGuire Veterans Affairs Medical Center, Richmond, VA, USA
| | - R Andrew Atkinson
- Randall Centre for Cell & Molecular Biophysics and Centre for Biomolecular Spectroscopy, King's College London, London, UK
| | - Roger Williams
- Institute for Hepatology London, Foundation for Liver Research, London, UK
- Faculty of Life Sciences & Medicine, King's College Hospital, London, UK
| | | | | | | | - Jasmohan S Bajaj
- Virginia Commonwealth University and McGuire Veterans Affairs Medical Center, Richmond, VA, USA
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