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. 2022 Jun 8:15:5513-5531.
doi: 10.2147/IJGM.S350104. eCollection 2022.

Gallstone Disease and Bacterial Metabolic Performance of Gut Microbiota in Middle-Aged and Older Patients

Doina Georgescu  1 , Ioana Ionita  1 , Ana Lascu  2 , Emil-Florin Hut  3 , Simona Dragan  4 , Oana-Elena Ancusa  1 , Mihai Ionita  1 , Despina Calamar-Popovici  1 , Liviu-Andrei Georgescu  5 , Daniel-Florin Lighezan  1
Affiliations

Gallstone Disease and Bacterial Metabolic Performance of Gut Microbiota in Middle-Aged and Older Patients

Doina Georgescu et al. Int J Gen Med. .

Abstract

Background: Gallstone disease (GSD) is more commonly presented in aged people.

Purpose: The purpose of the study was to explore the insights of metabolic performance of bacterial species from gut microbiota as well as the clinical background in middle-aged and elderly patients with GSD.

Patients and methods: This is an observational study concerning 120 research participants. Of those, 90 patients with symptomatic GSD addressed for cholecystectomy, average age 59.83 ± 15.32 years: 45 with cholesterol rich gallstones (CGSs), 45 with pigment gallstones (PGSs) and 30 healthy controls joined this observational study. Clinical examination, lab work-ups, upper and lower digestive video-endoscopies, abdominal ultrasound/CT and gallbladder motility assessment by Dodd's method were performed. Overall stool dysbiosis (DB) was assessed as 1 = minor, 2 = mild, 3 = severe, species being identified by matrix-assisted laser desorption ionization method. Stool samples from dysbiotic patients were analyzed by a next generation sequencing method with operational taxonomic unit identification.

Results: Patients with GSD presented with a significant high range of overall gut DB (p < 0.0001) when compared with controls. Those with CGSs compared with those having PGSs displayed significant clinical differences related to elderly age, lifestyle and diet particularities, obesity, dyslipidemia, nonalcoholic fatty liver disease, hypertension, type 2 diabetes mellitus or impaired glucose tolerance, as well as motility disturbances of gallbladder with a decrease of the ejection fraction. Significant increase of overall DB range and alterations of several functional bacterial species with a decrease of butyrate, lactate, acetate/propionate and methane producers, mucin degrading bacteria, biodiversity index of microbiota, as well as an increase of lipopolysaccharide positive bacteria were significantly present in patients with CGSs.

Conclusion: Middle-aged and elderly patients with GSD and a clinical background characterized by particular lifestyle, metabolic and gallbladder motility issues displayed significant modifications of biodiversity, overall gut DB and alterations of several functional bacterial species, with a decrease of their metabolic performance.

Keywords: biliary calculi; dysbiosis; intestinal functional bacteria.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

None
Graphical abstract
Figure 1
Figure 1
(A) Left: 2D abdominal ultrasound, white arrow pointing at GS. GB=gallbladder. (B) Right: Abdominal duplex ultrasound, white arrow pointing at GS. GS appears as echogenic zone (white) with acoustic shadow (black tail behind the stone).
Figure 2
Figure 2
GSs distribution according to gross description.
Figure 3
Figure 3
H index of alpha-biodiversity in patients with GSD: CGSs vs PGSs.
Figure 4
Figure 4
Quantitative distribution of the functional phyla in patient's GSD.
Figure 5
Figure 5
Quantitative distribution of the functional phyla in patient's GSD.
Figure 6
Figure 6
Quantitative distribution of the functional phyla in patient's GSD.
Figure 7
Figure 7
Quantitative distribution of the functional phyla in patient's GSD.
Figure 8
Figure 8
Quantitative distribution of the functional phyla in patient's GSD.
Figure 9
Figure 9
Quantitative distribution of the bacterial species producing butyric acid in patients with GSD.
Figure 10
Figure 10
Quantitative distribution of the bacterial species producing butyric acid in patients with GSD.
Figure 11
Figure 11
Quantitative distribution of the bacterial species producing butyric acid in patients with GSD.
Figure 12
Figure 12
Quantitative distribution of the bacterial species producing lactic acid in patients with GSD.
Figure 13
Figure 13
Quantitative distribution of the bacterial species producing lactic acid in patients with GSD.
Figure 14
Figure 14
Quantitative distribution of the bacterial species producing lactic acid in patients with GSD.
Figure 15
Figure 15
Quantitative distribution of the bacterial species producing acetate/propionate in patients with GSD.
Figure 16
Figure 16
Quantitative distribution of the bacterial species producing acetate/propionate in patients with GSD.
Figure 17
Figure 17
Quantitative distribution of the bacterial species producing acetate/propionate in patients with GSD.
Figure 18
Figure 18
Quantitative distribution of the bacterial species associated with mucin degradation in patients with GSD.
Figure 19
Figure 19
Quantitative distribution of the bacterial species associated with mucin degradation in patients with GSD.
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