摘要
目的 分析不同糖代谢水平湿热型患者的肠道菌群种类、丰度和结构差异,探讨肠道菌群变化与2型糖尿病发生发展的相关性。方法 选择2021年4—12月在苏州市中医医院内分泌科门诊就诊及于苏州市高新区横塘人民医院、苏州市沧浪新城社区卫生服务中心体检的湿热型人群100例,按照其血糖代谢水平分为健康组41例、糖尿病前期组38例、糖尿病早期组21例。收集3组人口学资料、临床代谢检测指标;采集粪便,采用16S rRNA高通量测序方法进行生物信息学分析,制作Alpha多样性指数柱状图,利用SPSS 22.0软件分析菌群差异。结果 3组性别、年龄、腰围、总胆固醇和低密度脂蛋白水平比较差异均无统计学意义(P均>0.05);糖尿病前期组和糖尿病早期组的体质指数、胰岛素抵抗指数、三酰甘油水平均明显高于健康组(P均<0.05),而高密度脂蛋白水平均明显低于健康组(P均<0.05),糖尿病前期组的胰岛素抵抗指数明显高于糖尿病早期组(P<0.05)。肠道菌群Alpha多样性分析:糖尿病前期组chao指数和ace指数均明显低于健康组(P均<0.05),3组shannon指数和simpson指数比较差异均无统计学意义(P均>0.05)。肠道菌群群落分析:与健康组比较,糖尿病前期与糖尿病早期组的Bacteroidetes、Acinetobacter、Oscillospira、Anoxybacillus、Pseudomonadales、Moraxellaceae丰度显著上调(P均<0.05),Blautia、Gemella、Erysipelas(纲、目、科)、Lachnospiraceae的丰度显著下调(P均<0.05)。结论 与健康人相比,湿热型血糖代谢异常者的肠道菌群总体丰富度明显下降,肠道菌群中往往富集更高比例的革兰阴性菌丰度更高、有益菌丰度更低。湿热型不同血糖代谢水平者间存在多种特异性变化菌,这些细菌可能是影响2型糖尿病发生发展的关键因子,有望成为有效防治2型糖尿病的新药靶标。
Objective It is to analyze the differences in species, abundance and structure of intestinal flora in patients with different glucose metabolism levels of dampness-heat type, and to explore the correlation between intestinal flora changes and the development of type 2 diabetes. Methods One hundred people of dampness-heat type who attended the outpatient clinic of the Department of Endocrinology of Suzhou Hospital of Traditional Chinese Medicine and were examined in Hengtang People’s Hospital of Suzhou High-tech Zone and Canglang New Town Community Health Service Center from April to December 2021 were selected, and were divided into 41 cases in the healthy group, 38 cases in the prediabete group, and 21 cases in the early diabetes group according to their blood glucose metabolism level. The demographic data and clinical metabolic testing indexes were collected from the three groups;stools were collected and bioinformatics analysis was performed by 16S rRNA high-throughput sequencing method, Alpha diversity index histograms were produced, and differences in flora were analyzed using SPSS software. Results There were no statistically significant differences in the gender, age, waist circumference, total cholesterol and low-density lipoprotein levels among the three groups(all P>0.05);The body mass index, insulin resistance index and the level of triacylglycerol were significantly higher in the prediabetes and early diabetes groups than those in the healthy group(all P<0.05), while the levels of high-density lipoprotein were significantly lower that that in the healthy group(P<0.05), the insulin resistance index was significantly higher in the pre-diabetic group than that in the early diabetic group(P<0.05). Alpha diversity analysis of intestinal flora: the chao index and ace index of the pre-diabetic group were significantly lower than those of the healthy group(all P<0.05), and the differences in the shannon index and simpson index among the three groups were not statistically significant(all P>0.05). Analysis of intestinal flora community: compared with the healthy group, the abundance of Bacteroidetes, Acinetobacter, Oscillospira, Anoxybacillus, Pseudomonadales, Moraxellaceae was significantly upregulated in the pre-diabetic and early diabetic groups(all P<0.05), the abundance of Blautia, Gemella, Erysipelas(phylum, order, family), and Lachnospiraceae was significantly down-regulated(all P<0.05). Conclusion Compared with healthy people, the overall richness of intestinal flora in patients with abnormal blood glucose metabolism were decreased significantly. The intestinal flora of patients with glucose homeostasis imbalance tends to be enriched with a higher proportion of gram-negative bacteria, as well as lower levels of beneficial bacteria abundance. There are a variety of specific changes in bacteria among patients with different blood glucose metabolism levels, which may be the key factors affecting the occurrence and development of type 2 diabetes, and are expected to become a new drug target for effective prevention and treatment of this disease.
作者
黄佳梅
黄菲
HUANG Jiamei;HUANG Fei(Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China;Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,Jiangsu,China;Suzhou Academy of Wumen Chinese Medicine,Suzhou 215009,Jiangsu,China)
出处
《现代中西医结合杂志》
CAS
2022年第24期3378-3384,共7页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
苏州市姑苏卫生人才计划培养项目(GSWS2020079)
苏州市民生科技示范项目(SS202006)。
关键词
肠道菌群
湿热型
糖代谢异常
intestinal flora
dampness-heat type
abnormal glucose metabolism
