摘要
目的通过检测和比较不同受孕方式及是否并发妊娠期糖尿病(gestational diabetes mellitus,GDM)孕产妇的肠道菌群,明确辅助生殖技术(assisted reproductive technology,ART)及GDM孕产妇肠道菌群的特异性表达,分析其机制,为今后预防干预、促进ART妊娠母婴健康提供理论基础。方法选取2016年2月至4月在厦门大学附属成功医院(陆军第73集团军医院)产科定期产检后住院分娩的足月妊娠、近3个月内未使用过抗生素并无肠道疾病的孕产妇,按ART和自然妊娠两种不同受孕方式及是否并发GDM纳入60例,分为4组,分别为ART并发GDM组18例、ART无GDM组14例、自然妊娠并发GDM组17例和自然妊娠无GDM组11例,记录孕妇的身高、体重、年龄、孕周、居住地、妊娠合并症并发症、近3 d饮食情况,以及分娩方式、分娩结局等临床资料;收集孕产妇入院或分娩之前24 h的粪便5~10 g;提取肠道菌群DNA;同时基于16S rRNA基因测序技术,分析样本中肠道菌群的分布情况;用于后续的菌群量化研究及代谢物分析。结果4组样本的肠道菌群主要由厚壁菌门和拟杆菌门组成;不论何种受孕方式,GDM孕产妇的双歧杆菌均比其他孕产妇减少;ART孕产妇肠道菌群的厚壁菌门丰度降低,变形菌门所属菌群丰度增加(P<0.05),肠道菌群中的Alpha多样性降低(P<0.05);ART并发GDM组肠道菌群的丰度、多样性降低,肠道菌群的组成比例失衡,且出现较高丰度的条件致病菌克雷伯氏菌;ART并发GDM组和ART无GDM组的Alpha多样性较为一致,而自然妊娠并发GDM组和自然妊娠无GDM组之间的Alpha多样性则存在明显差异。结论补充双歧杆菌可能有助于预防或者治疗GDM;ART并发GDM组的肠道菌群组成结构比例失调;ART大剂量激素的使用会导致孕产妇的肠道菌群失衡;ART导致的肠道菌群变化远大于GDM对肠道菌群的作用。
Objective By detecting and comparing the intestinal flora of pregnant women with different mode of conception and whether they were complicated with gestational diabetes mellitus(GDM),to find the specific expression of intestinal flora in GDM pregnant women after assisted reproductive technology(ART),and analyze its mechanism,so as to provide theoretical basis for the prevention and intervention in the future and the promotion of maternal and infant health after ART.Methods A total of 60 pregnant women who were hospitalized and gave birth after regular prenatal check-up in the Department of Obstetrics,Chenggong Hospital Affiliated to Xiamen University(Army Group 73th Military Hospital)from February to April 2016 were recruited.According to different mode of conception,they were divided into four groups:ART complicated with GDM(n=18),ART no complicated with GDM(n=14),spontaneous pregnancy complicated with GDM(n=17)and spontaneous pregnancy no complicated with GDM(n=11).General clinical data including height,weight,age,gestational age,place of residence,pregnancy complications,diet in the last three days,as well as delivery mode and delivery outcome were recorded.5-10 grams feces of these pregnant women were collected respectively at the time of admission or 24 hours before delivery to extract the intestinal flora DNA of the samples.Meanwhile,based on the 16S rRNA gene sequencing technology,the distribution of intestinal flora in the samples was analyzed for the subsequent quantitative study of the flora and the analysis of metabolites.Results The four groups of samples were mainly composed of Firmicutes and Bacteroidetes.No matter what kind of pregnancy mode,the Bifidobacteria in GDM group was less than that in other groups.The abundance of Firmicutes in the intestinal flora of ART pregnancy women was downregulated,and the abundance of Proteus increased(P<0.05).The diversity of Alpha in intestinal flora of ART pregnancy women decreased(P<0.05).The abundance and diversity of intestinal flora in ART complicated with
作者
王方
郑剑兰
汪文雁
彭芳林
Wang Fang;Zheng Jianlan;Wang Wenyan;Peng Fanglin(Department of Obstetrics,Chenggong Hospital Affiliated to Xiamen University,Army Group 73th Military Hospital,Fujian,Xiamen 361003,China;Department of Obstetrics,Binhu Hospital,Anhui,Hefei 230601,China)
出处
《发育医学电子杂志》
2021年第2期114-121,共8页
Journal of Developmental Medicine (Electronic Version)
基金
厦门市卫生健康委科研项目(3502Z20184066)。
关键词
辅助生殖技术
妊娠期糖尿病
肠道菌群
菌群多样性
Assisted reproductive technology
Gestational diabetes mellitus
Intestinal flora
Flora diversity
