摘要
目的分析2型糖尿病(T2DM)及糖尿病肾病(DKD)患者微炎症情况和肠道微生物多样性。方法将2016年4月至2019年7月在我院进行治疗的68例T2DM患者(T2DM组)和57例DKD患者(DKD组)纳入研究,选择同期于我院进行健康体检的36例志愿者作为对照组。收集3组对象一般资料、血液标本和粪便标本,测定血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平,并对肠道细菌进行16S rDNA序列测序。比较3组对象一般资料,血液指标,肠道菌群门水平构成情况,肠道菌群多样性,肠道菌属差异性,并对患者炎性指标与菌群种类进行相关性分析。结果DKD组患者糖尿病病程长于T2DM组(P<0.05)。与对照组比较,T2DM组和DKD组患者BMI、舒张压和收缩压增加,TC、TG、LDL-C、HbAlc、FBG、hs-CRP、IL-6水平升高,HDL-C水平降低(均P<0.05)。3组对象肠道菌群以厚壁菌门、拟杆菌门和变形菌门为主。T2DM组和DKD组患者拟杆菌门/厚壁菌门、蓝藻菌门及放线菌门比例均低于对照组(均P<0.05)。与对照组比较,T2DM和DKD患者肠道毛螺菌属、罗氏菌属、粪球菌属丰度升高,双歧杆菌属丰度降低(t=34.2692、23.1578、3.5897、12.3648,P<0.0001、<0.0001、=0.0122、=0.0361)。DKD组患者毛螺菌属和粪球菌属丰度高于T2DM组(t=65.3492、13.5731,P=0.0213、0.0013)。T2DM组和DKD组患者血清hs-CRP水平与肠道毛螺菌属、瘤胃菌科、粪球菌属、梭杆菌属呈正相关,与红蝽菌科呈负相关;血清IL-6水平与瘤胃菌科呈正相关,与红蝽菌科、双歧杆菌属、乳杆菌属呈负相关(均P<0.05)。结论2型糖尿病患者普遍存在微炎症和肠道菌群失衡,微炎症程度与肾脏病变和肠道菌群数量密切相关。T2DM与DKD患者在肠道菌群结构上具有一致性和差异性,肠道菌群检测有可能成为预测T2DM�
Objective To observe microinflammation and intestinal microbial diversity in patients with type 2 diabetes mellitus(T2 DM)and diabetes kidney disease(DKD).Methods A total of 68 patients with T2 DM(T2 DM group),57 patients with DKD(DKD group)and 36 healthy individuals(control group)in our hospital from April 2016 to July 2019 were enrolled.General information and specimens of blood and stool were collected.The levels of serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glycated hemoglobin(HbAlc),fasting blood glucose(FBG),high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)were detected.16 S rDNA gene sequence of intestinal bacteria was sequenced.General information,blood indexes,composition of intestinal phylum,diversity of intestinal flora and difference of intestinal genus were compared among the three groups.Then the correlation between the inflammatory indexes and the types of bacteria was analyzed.Results The course of diabetes in DKD group was longer than that in T2 DM group(P<0.05).BMI,diastolic blood pressure,systolic blood pressure,and levels of TC,TG,LDL-C,HbAlc,FBG,hs-CRP and IL-6 were the lowest of control group,followed by T2 DM group and DKD group,with statistical differences(all P<0.05).Intestinal floras in the three groups were mainly Firmicutes,Bacteroidetes and Proteobacteria.The proportions of Bacteroidetes/Firmicutes,Cyanobacteria and Actinomycetes in the T2 DM group and DKD group were lower than those in the control group(P<0.05).Compared with the control group,the abundance of Lachnospira,Rothia and Coprococcus increased in T2 DM and DKD patients,while the abundance of Bifidobacterium decreased(t=34.2692,23.1578,3.5897,12.3648,P<0.0001,<0.0001,=0.0122,=0.0361).The abundance of Lachnospira and Coprococcus in DKD group was higher than that in T2 DM group(t=65.3492,13.5731,P=0.0213,0.0013).Serum hs-CRP level of T2 DM group and DKD group was positively correlated with Lachnospira,Ruminococcaceae,Copro
作者
冯春念
曾琳智
王仕均
周会
罗晓红
FENG Chunnian;ZENG Linzhi;WANG Shijun;ZHOU Hui;LUO Xiaohong(Department of Laboratory,Xuanhan People′s Hospital,Xuanhan,Sichuan 636150,China)
出处
《中国微生态学杂志》
CAS
CSCD
2020年第11期1273-1278,共6页
Chinese Journal of Microecology
关键词
2型糖尿病
糖尿病肾病
微炎症反应
肠道微生物
Type 2 diabetes mellitus
Diabetes kidney disease
Microinflammatory response
Intestinal microorganism
