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Meta-Analysis
. 2025 Jan 13;25(1):16.
doi: 10.1186/s12876-025-03589-5.

Associations between changes in the gut microbiota and liver cirrhosis: a systematic review and meta-analysis

Ye Liu  1   2   3 , Ziwei Chen  2 , Chang Li  1   2 , Tianhan Sun  4 , Xuanmei Luo  2 , Boyue Jiang  4 , Meilan Liu  4 , Qing Wang  4 , Tong Li  4 , Jianfu Cao  4 , Yayu Li  2 , Yuan Chen  2 , Lu Kuai  2 , Fei Xiao  5   6   7   8 , Hongtao Xu  9   10 , Hongyuan Cui  11   12
Affiliations
Meta-Analysis

Associations between changes in the gut microbiota and liver cirrhosis: a systematic review and meta-analysis

Ye Liu et al. BMC Gastroenterol. .

Abstract

Objective: Summaries of the relationships between the microbiota and liver cirrhosis and their conclusions are not consistent. This study describes microbial differences in patients with liver cirrhosis by performing a meta-analysis.

Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library and collected related articles published before March 10, 2024. Ratio of autochthonous to non-autochthonous taxa was calculated as the cirrhosis dysbiosis ratio (CDR). Using a random-effects model, the standard mean deviation (SMD) and 95% confidence interval (CI) were calculated. We subsequently performed subgroup, sensitivity, and publication bias analyses. cirrhosis dysbiosis ratio.

Results: A total of 53 eligible papers including 5076 participants were included. The pooled estimates revealed a moderately significant reduction in gut microbiome richness in patients with liver cirrhosis compared with controls, including the Shannon, Chao1, observed species, ACE, and PD indices, but no significant difference was observed for the Simpson index. Over 80% of the studies reported significant differences in β diversity. Families Enterobacteriaceae and Pasteurellaceae, belonging to the phylum Proteobacteria, along with the family Streptococcaceae and the genera Haemophilus, Streptococcus, and Veillonella, were significantly associated with liver cirrhosis compared to the control group. In contrast, the healthy group exhibited a higher abundance of the class Clostridia, particularly the families Lachnospiraceae and Ruminococcaceae, which are known for their diversity and role as common gut commensals. Furthermore, the class Bacilli, predominantly represented by the genus Streptococcus, was markedly enriched in the cirrhosis group.

Conclusions: The microbiota richness of liver cirrhosis patients was lower than that of healthy controls. Alterations in gut microbiota linked to liver cirrhosis were characterized by a decrease in Lachnospiraceae, Ruminococcaceae, and Clostridia and an enrichment of Enterobacteriaceae, Pasteurellaceae, Streptococcaceae, Bacilli, and Streptococcus.

Keywords: Gut microbiota; Intestinal microbiota; Liver cirrhosis; Meta-analysis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: This manuscript does not include details, images or videos relating to a person; therefore, consent for publication is not required. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the literature search
Fig. 2
Fig. 2
Forest plots comparing alpha diversity between patients with liver cirrhosis and healthy controls. This figure shows the overall analysis. For each study, the estimate of differences in the mean alpha diversity index and its 95% confidence interval (95% CI) was plotted with a diamond. SMD, standard mean difference; I2, I-square heterogeneity statistic
Fig. 3
Fig. 3
Comparison of beta diversity between patients with liver cirrhosis and healthy controls
See this image and copyright information in PMC

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