Characteristics of the microbiome in patients with symptomatic uncomplicated colonic diverticular disease in the central region of Ukraine

Abstract

The aim of the study was to analyze the age structure, correlation with body mass index in patients with symptomatic uncomplicated diverticular disease (SUDD) in the central region of Ukraine. To reveal the prevalence of left-sided, right-sided or total diverticular lesions of the large intestine, to evaluate the microbiota composition, to identify peculiarities of the enterotype. Materials and methods. The study included 125 patients with SUDD aged 18 to 90 years who were at a Gastroenterology Hospital in the period from 2019 to 2022. All the patients were residents of the central region of Ukraine. Body mass index was calculated for all patients, total colonoscopy was performed, and fecal analysis was done using culturing and qRT-PCR methods. Results. The incidence of SUDD among patients in the central region of Ukraine increases with age and reaches its peak in the 71–80 age group. Almost all age groups are dominated by women. Left-sided localization of diverticula occurs in 84.8 % of patients, right-sided in 8.0 %, total in 7.2 %. The majority of patients with diverticular disease (87.2 %) are overweight or with varying degrees of obesity. Patients with SUDD are characterized by a decrease in the main representatives of obligate microflora, namely, Bifidobacterium, Lactobacillus, Escherichia coli. In 46.4 % of patients, representatives of opportunistic flora are detected, in 24.0 % – an increase in fungi from the genus Candida. Also, changes in enterotypes are detected, namely an increase in Firmicutes and Actinobacteria, with a decrease in Bacteroides. The number of Faecalibacterium prausnitzii tends to decrease, while the Akkermansia muciniphila count is unchanged. Conclusions. The incidence of SUDD increases with age among the population of the central region of Ukraine. Among patients with SUDD, women predominate in almost all age groups. 87.2 % of patients with SUDD are overweight or with various degrees of obesity. The left-sided localization of diverticula prevails among patients with SUDD in the central region of Ukraine – 84.8 %. Patients with SUDD in the central region of Ukraine are characterized by the decrease in the main representatives of obligate microflora, namely: Bifidobacterium, Lactobacillus, Escherichia coli. In 46.4 % of patients with SUDD, representatives of conditionally pathogenic flora are found, in 24.0 % – the increase in fungi from the genus Candida. Changes in enterotypes are detected, namely the increase in Firmicutes and Actinobacteria, with the decrease in Bacteroides. Faecalibacterium prausnitzii tends to decrease, while Akkermansia muciniphila are unchanged.