摘要
目的探讨不同类型非酒精性脂肪性肝病(NAFLD)患者肠道菌群结构与生物化学指标改变的相关性,以期为NAFLD临床诊断和防治提供依据。方法随机纳入NAFLD患者(NAFLD组)48例、NAFLD合并2型糖尿病患者(NAFLD合并2型糖尿病组)40例和体检健康者(健康组)30例,检测其体质量指数及血清中丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、尿酸和空腹血糖,用酶联免疫吸附法检测血清中肿瘤坏死因子-α和空腹胰岛素并计算胰岛素抵抗指数。用16SrDNA高通量测序检测3组对象肠道菌群,最后综合分析各研究因素间的相关性。各组之间的比较采用χ^2检验,符合正态分布且方差齐的多组间比较采用单因素方差分析,进一步两两比较用LSD法,不符合正态分布或方差齐性的多组间比较采用K-W秩和检验。结果NAFLD组体质量指数、天冬氨酸氨基转移酶、甘油三酯、总胆固醇、低密度脂蛋白、尿酸、肿瘤坏死因子-α、空腹胰岛素、胰岛素抵抗指数均高于健康组,高密度脂蛋白低于健康组,差异均有统计学意义(P值均<0.05)。与NAFLD组比较,NAFLD合并2型糖尿病组年龄、空腹血糖和胰岛素抵抗指数升高,体质量指数、天冬氨酸氨基转移酶、总胆固醇和高密度脂蛋白降低,差异均有统计学意义(P值均<0.05)。与健康组比较,NAFLD组厚壁菌门丰度降低(P=0.016),NAFLD合并2型糖尿病组厚壁菌门丰度降低(P<0.001)。NAFLD合并2型糖尿病组拟杆菌门丰度高于健康组,差异有统计学意义(P=0.006)。在"属"水平,NAFLD组Roseburia、Subdoligranulum的丰度降低,且NAFLD合并2型糖尿病组Roseburia明显降低,差异均有统计学意义(P值均<0.05);此外,NAFLD合并2型糖尿病组Faecalibacterium、Blautia、Anaerostipes、Fusicatenibacter丰度均低于健康组,差异均有统计学意义(P值均<0.001)。Fusicatenibacter、Blautia、Anae
Objective To investigate the relationship between gut microbiota structure and biochemical changes in patients with different types of nonalcoholic fatty liver disease(NAFLD),in order to provide evidence for clinical diagnosis and prevention of NAFLD.Methods Forty-eight NAFLD cases(NAFLD group),40 NAFLD cases with type 2 diabetes mellitus(NAFLD combined with type 2 diabetes mellitus group)and 30 healthy cases(healthy group)were randomly enrolled,and their body mass index,serum alanine aminotransferase,aspartate aminotransferase,total bilirubin,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein and uric acid were measured.Serum levels of TNF-alpha and fasting insulin were measured using ELISA,and then insulin resistance index was calculated.The gut microbiota of three groups of subjects was detected using 16S rDNA-based high-throughput sequencing.Lastly,the correlations between the various factors were analyzed.The comparison among groups was conducted by 2 test,and one-way ANOVA was used for comparison among groups with normal distribution and homogeneity of variance.Furthermore,the LSD method was used to compare the two groups.K-W rank sum test was used for comparison among groups without normal distribution or homogeneity of variance.Results Body mass index,aspartate aminotransferase,triglyceride,total cholesterol,low density lipoprotein,uric acid,tumor necrosis factor-alpha,fasting insulin and insulin resistance index of NAFLD group were higher than healthy group,while the high-density lipoprotein was lower in the healthy group,and the difference was statistically significant(P<0.05).Compared with NAFLD group,the life expectancy,fasting blood glucose and insulin resistance index of NAFLD combined with type 2 diabetes mellitus group were higher,while the body mass index,aspartic acid aminotransferase,total cholesterol and HDL levels were decreased,and the difference was statistically significant(P<0.05).NAFLD group(P=0.016)had decreased abundance of firmicutes than healthy group,and
作者
任士萌
梅璐
黄煌
曹少锋
赵锐豪
郑鹏远
Ren Shimeng;Mei Lu;Huang Huang;Cao Shaofeng;Zhao Ruihao;Zheng Pengyuan(Department of Gastroenterology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2019年第5期369-375,共7页
Chinese Journal of Hepatology
基金
国家自然科学基金(81370494)
河南省医学科技攻关项目(201702113)
河南省重点研发与推广专项科技攻关项目(182102310179).
关键词
脂肪肝
非酒精性
胰岛素抵抗
肠道菌群
炎症反应
Fatty liver,non-alcoholic
Insulin resistance
Gut microbiota
Inflammatory reaction
