Hepatic glycogen storage diseases are associated to microbial dysbiosis

PLoS One. 2019 Apr 2;14(4):e0214582. doi: 10.1371/journal.pone.0214582. eCollection 2019.

Abstract

Introduction: The gut microbiome has been related to several features present in Glycogen Storage Diseases (GSD) patients including obesity, inflammatory bowel disease (IBD) and liver disease.

Objectives: The primary objective of this study was to investigate associations between GSD and the gut microbiota.

Methods: Twenty-four GSD patients on treatment with uncooked cornstarch (UCCS), and 16 healthy controls had their faecal microbiota evaluated through 16S rRNA gene sequencing. Patients and controls were ≥3 years of age and not on antibiotics. Faecal pH, calprotectin, mean daily nutrient intake and current medications were recorded and correlated with gut microbiome.

Results: Patients' group presented higher intake of UCCS, higher prevalence of IBD (n = 04/24) and obesity/overweight (n = 18/24) compared to controls (n = 0 and 06/16, respectively). Both groups differed regarding diet (in patients, the calories' source was mainly the UCSS, and the intake of fat, calcium, sodium, and vitamins was lower than in controls), use of angiotensin-converting enzyme inhibitors (patients = 11, controls = 0; p-value = 0.001) multivitamins (patients = 22, controls = 01; p-value = 0.001), and mean faecal pH (patients = 6.23; controls = 7.41; p = 0.001). The GSD microbiome was characterized by low diversity and distinct microbial structure. The operational taxonomic unit (OTU) abundance was significantly influenced by faecal pH (r = 0.77; p = 6.8e-09), total carbohydrate (r = -0.6; p = 4.8e-05) and sugar (r = 0.057; p = 0.00013) intakes.

Conclusions: GSD patients presented intestinal dysbiosis, showing low faecal microbial diversity in comparison with healthy controls. Those findings might be due to the disease per se, and/or to the different diets, use of UCSS and of medicines, and obesity rate found in patients. Although the main driver of these differences is unknown, this study might help to understand how the nutritional management affects GSD patients.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Angiotensin-Converting Enzyme Inhibitors
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Dysbiosis*
  • Energy Intake
  • Feces
  • Female
  • Gastrointestinal Microbiome
  • Glycogen Storage Disease / microbiology*
  • Glycogen Storage Disease / physiopathology
  • Humans
  • Hydrogen-Ion Concentration
  • Inflammation
  • Inflammatory Bowel Diseases / microbiology*
  • Inflammatory Bowel Diseases / physiopathology
  • Leukocyte L1 Antigen Complex
  • Liver / metabolism*
  • Male
  • Obesity / complications
  • Overweight / complications
  • Phenotype
  • Principal Component Analysis
  • RNA, Ribosomal, 16S / genetics
  • Starch
  • Young Adult

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Leukocyte L1 Antigen Complex
  • RNA, Ribosomal, 16S
  • Starch

Grants and funding

The present study was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS)- EDITAL PRONEX FAPERGS/CNPq 12/2014, processo 16/2551-0000492-7; Fundo de Incentivo à Pesquisa e Eventos do Hospital de Clínicas de Porto Alegre (FIPE-HCPA)- n. 150218 and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.