Association of Sarcopenia and Gut Microbiota Composition in Older Patients with Advanced Chronic Kidney Disease, Investigation of the Interactions with Uremic Toxins, Inflammation and Oxidative Stress

• Main Authors: Elisabetta Margiotta, Lara Caldiroli, Maria Luisa Callegari, Francesco Miragoli, Francesca Zanoni, Silvia Armelloni, Vittoria Rizzo, Piergiorgio Messa, Simone Vettoretti
• Format: Article
• Language: English
• Published: MDPI AG 2021-07-01
• Series: Toxins
• Subjects: chronic kidney disease; sarcopenia; gut microbiota; inflammation; oxidative stress
• Online Access: https://www.mdpi.com/2072-6651/13/7/472

Sarcopenia is a prevalent condition in chronic kidney disease (CKD). We determined gut microbiota (gMB) composition in CKD patients with or without sarcopenia. Furthermore, we investigated whether in these patients, there was any association between gMB, uremic toxins, inflammation and oxidative stress. We analyzed gMB composition, uremic toxins (indoxyl sulphate and p-cresyl sulphate), inflammatory cytokines (interleukin 10, tumor necrosis factor α, interleukin 6, interleukin 17, interleukin 12 p70, monocyte chemoattractant protein-1 and fetuin-A) and oxidative stress (malondialdehyde) of 64 elderly CKD patients (10 < eGFR < 45 mL/min/1.73 m², not on dialysis) categorized as sarcopenic and not-sarcopenic. Sarcopenia was defined according to European Working Group on Sarcopenia in Older People 2 criteria. Sarcopenic patients had a greater abundance of the <i>Micrococcaceae</i> and <i>Verrucomicrobiaceae</i> families and of <i>Megasphaera</i>, <i>Rothia</i>, <i>Veillonella</i>, <i>Akkermansia</i> and <i>Coprobacillus</i> genera. They had a lower abundance of the <i>Gemellaceae</i> and <i>Veillonellaceae</i> families and of <i>Acidaminococcus</i> and <i>Gemella</i> genera. GMB was associated with uremic toxins, inflammatory cytokines and MDA. However, uremic toxins, inflammatory cytokines and MDA were not different in sarcopenic compared with not-sarcopenic individuals, except for interleukin 10, which was higher in not-sarcopenic patients. In older CKD patients, gMB was different in sarcopenic than in not-sarcopenic ones. Several bacterial families and genera were associated with uremic toxins and inflammatory cytokines, although none of these latter substantially different in sarcopenic versus not-sarcopenic patients.