Objective
Minimal hepatic encephalopathy (MHE) caused by liver cirrhosis is quite prevalent, and approximately one-half of MHE patients have experience sleep disturbances. This study systematically evaluated the association between sleep disturbances and altered intestinal microbiota in patients with MHE caused by hepatitis B-related liver cirrhosis.
Methods
Ninety-eight and 45 MHE patients were respectively included in the exploration and validation cohorts. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to evaluate sleep disturbances. The intestinal microbiota of self-collected fecal samples was analyzed using the amplicon sequencing of bacterial 16S ribosomal RNA gene.
Results
MHE patients with sleep disturbances were characterized by lower bacterial diversities and distinct microbial composition in comparison to those without sleep disturbances. The relative abundances of Salivarius, Veillonella, Klebsiella, and Eubacterium were independent predictors of sleep disturbances in MHE patients. In MHE patients with sleep disturbances, the relative abundances of Salivarius and Veillonella were positively correlated with PSQI scores, respectively. Functional modules involved in lipopolysaccharide biosynthesis, as well as protein digestion and absorption, were increased in the microbiome of MHE patients with sleep disturbances.
Conclusion
Salivarius and Veillonella may be potential diagnostic biomarkers and therapeutic targets for sleep disturbances in MHE patients.