Abstract:

Objective To investigate the correlation between serum bilirubin level and the imbalance of normal gut microbiota in neonates with cholestatic jaundice. Methods A total of 109 neonates with cholestatic jaundice treated in Nanyang Central Hospital from August 2019 to August 2021were selected as the cholestatic jaundice group, 68 neonates with breast milk jaundice were selected as the breast milk jaundice group, and 80 healthy neonates during the same period were selected as the healthy group. Serum bilirubin level andgut microbiotain stools were detected. Differences in the dominant flora at the level of phylum and genus in three groups were compared. The correlation between serum bilirubin level and the imbalance of normal gut microbiota was analyzed by Pearson’s correlation coefficient. Results Serum level of alanine aminotransferase (ALT) and direct bilirubin and total bilirubin ratio (DBIL/TBIL) in cholestatic jaundice group were significantly higher than those in healthy group and breast milk jaundice group (all P<0.05). The proportion of grade Ⅱ and Ⅲ imbalance of gut microbiota was significantly higher in cholestatic jaundice group than that in the healthy group and breast milk jaundice group (P<0.05).The abundances of Bacteroides and Firmicutes in cholestatic jaundice group were significantly higher than those in breast milk jaundice group and healthy group (P<0.05).The abundances of Bifidobacteria and Lactobacillus in cholestatic jaundice group were significantly lower than that in healthy group and breast milk jaundice group (P<0.05), and the abundances of Escherichia coli and Enterococcus in cholestatic jaundice group weresignificantly higher than that in healthy group and breast milk jaundice group (P<0.05). The ratio of Bifidobacteria/Escherichia coli (B/E) in cholestatic jaundice group was significantly lower than that in healthy group and breast milk jaundice group (P<0.05).ALT, TBIL, DBIL, DBIL/TBIL were positively correlated with the abundances of Bacteroides and Firmicutes (all P<0.05), and negatively correlated with that of Actinomyces (all P<0.05).TBIL was negatively correlated with the abundance of Bifidobacterium and B/E (P<0.05), and positively correlated with abundances of Escherichia coli and Enterococcus (P<0.05).DBIL was negatively correlated with the abundance of Bifidobacterium and B/E (P<0.05) DBIL/TBIL were negatively correlated with the abundances of Bifidobacterium, Escherichia coli, and Enterococcus, and B/E (all P<0.05). Conclusion The gut microbiota of neonates with cholestatic jaundice is imbalance, with significantly reduced abundance of Bifidobacteria, and the serum bilirubin level has a certain correlation with the gut microbiota. An active supplement of probiotics may be an effective way to treat cholestatic jaundice.

Key words: jaundice, neonatal, bilirubin, gut microbiota imbalance, Bifidobacterium