Interaction of Microbiome, Diet, and Hospitalizations Between Brazilian and American Patients With Cirrhosis.

Autor:	Álvares-da-Silva MR; Department of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Oliveira CP; Department of Medicine, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil., Fagan A; Department of Medicine, Virginia Commonwealth University, McGuire Veterans Affairs Medical Center, Richmond, Virginia., Longo L; Department of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Thoen RU; Department of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Yoshimura Zitelli PM; Department of Medicine, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil., Tanaka Ferreira RM; Department of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil., Mcgeorge S; Department of Medicine, Virginia Commonwealth University, McGuire Veterans Affairs Medical Center, Richmond, Virginia., Shamsaddini A; Microbiome Analysis Center, George Mason University, Manassas, Virginia., Farias AQ; Department of Medicine, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil., Sikaroodi M; Microbiome Analysis Center, George Mason University, Manassas, Virginia., Gillevet PM; Microbiome Analysis Center, George Mason University, Manassas, Virginia., Bajaj JS; Department of Medicine, Virginia Commonwealth University, McGuire Veterans Affairs Medical Center, Richmond, Virginia. Electronic address: jasmohan.bajaj@vcuhealth.org.
Jazyk:	angličtina
Zdroj:	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2022 Apr; Vol. 20 (4), pp. 930-940. Date of Electronic Publication: 2021 Apr 02.
DOI:	10.1016/j.cgh.2021.03.045
Abstrakt:	Background & Aims: Gut microbiota are affected by diet, country, and affect outcomes in cirrhosis. Western diets are associated with dysbiosis. Comparisons with other diets is needed. We aimed to compare cirrhosis patients from the United States with cirrhosis patients from Brazil with respect to diet, microbiota, and impact on hospitalizations. Methods: Healthy controls and compensated/decompensated outpatients with cirrhosis from the United States and Brazil underwent dietary recall and stool for 16S ribosomal RNA sequencing. Demographics and medications/cirrhosis details were compared within and between countries. Patients with cirrhosis were followed up for 90-day hospitalizations. Regression for Shannon diversity was performed within cirrhosis. Regression for hospitalizations adjusting for clinical and microbial variables was performed. Results: Model for end-stage liver disease (MELD), diabetes, ascites, and albumin were similar, but more Americans were men, had higher hepatic encephalopathy and alcohol/hepatitis C etiology, with lower nonalcoholic fatty liver disease than Brazilians. Brazilians had higher cereal, rice, and yogurt intake vs the United States. As disease progressed, cereals, rice/beans, coffee, and chocolate consumption was reduced. Microbial diversity was higher in Brazilians. Within cirrhosis, high diversity was related to Brazilian origin (P < .0001), age, and cereal intake (P = .05), while high MELD scores (P = .009) and ascites (P = .05) did the reverse. Regardless of stage, beneficial taxa and taxa associated with grant and yogurt intake were higher (Ruminococcaceae, Christensenellacae, and Prevotellaceae), while pathobionts (Porphyromonadaceae, Sutterellaceae, and Enterobacteriaceae) were lower in Brazilians. More Americans were hospitalized vs Brazilians (P = .002). On regression, MELD (P = .001) and ascites (P = .001) were associated with higher hospitalizations, while chocolate (P = .03) and Brazilian origin (P = .001) were associated with lower hospitalizations with/without microbiota inclusion. Conclusions: Brazilian cirrhotic patients follow a diet richer in cereals and yogurt, which is associated with higher microbial diversity and beneficial microbiota and could contribute toward lower hospitalizations compared with a Western-diet-consuming American cohort. (Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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