摘要
目的:探讨2型糖尿病(T2DM)湿热困脾证、气阴两虚证患者肠道菌群的结构特征和功能差异。方法:选择2018年6月至2020年1月就诊于南京中医药大学附属南京中医院的T2DM湿热困脾证患者62例,气阴两虚证患者60例,收集其血清及粪便样本,比较两证型患者体质量指数(BMI),糖脂代谢,空腹胰岛素(FINS),空腹C肽(FCP),胰岛素抵抗指数(HOMA-IR),粪便样本提取DNA建库,采用高通量16S rDNA测序技术,对2组肠道菌群及菌群代谢通路分析比较。结果:①与气阴两虚证患者比较,湿热困脾证患者的BMI,空腹血糖(FPG),餐后2 h血糖(2 h PBG),总胆固醇(TC),甘油三酯(TG),低密底脂蛋白(LDL),FINS,FCP,HOMA-IR均明显升高,HDL明显降低(P<0.05,P<0.01)。②两组菌群物种组成及差异,在纲水平上,以拟杆菌纲,梭状芽胞杆菌纲,γ蛋白杆菌纲等为主,气阴两虚证的梭状芽胞杆菌、柔膜菌纲、疣微菌纲的相对丰度明显高于湿热困脾证(P<0.05);目水平下以拟杆菌目、梭菌目、肠杆菌目等为主,气阴两虚证的梭菌目、丹毒丝菌目、疣微菌目的相对丰度明显高于湿热困脾证,而气单胞菌目则在湿热困脾证高于气阴两虚证(P<0.05);科水平下以拟杆菌科、普氏菌科、瘤胃球菌科等为主,其中气阴两虚证的瘤胃球菌科、紫单胞菌科、丹毒丝菌科等的相对丰度明显高于湿热困脾证(P<0.05);属水平下以拟杆菌属、普氏菌属、副拟杆菌属等为主,其中气阴两虚证的副拟杆菌属、丁酸弧菌属、瘤胃梭菌属等的相对丰度显著高于湿热困脾证,而在湿热困脾组的克雷伯菌属、巨球型菌属则高于气阴两虚证(P<0.05)。③基于运算分类单位(OTU)的Venn分析发现湿热困脾证和气阴两虚证患者独有的OUT分别49,47个。④基于OTU的β多样性和α分析,结果Shannon,Simpson指数差异均具有统计学意义,Ace,Chao指数差异无统计学意义,气阴两虚证患者的肠道微生物多样性高于湿热困脾
Objective:To explore the structural characteristics and functional differences of intestinal flora in patients with type 2 diabetes mellitus(T2DM)of dampness heat trapping spleen(DHTS)syndrome and Qi-Yin deficiency(QYD)syndrome.Method:From June 2018 to January 2020,62 T2DM patients with DHTS syndrome and 60 with QYD syndrome were selected from Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine.Serum and fecal samples were collected to compare body mass index(BMI),glucose and lipid metabolism,fasting insulin(FINS)and fasting C-peptide(FCP)levels,and homeostasis model assessment of insulin resistance(HOMA-IR)of the two syndrome types.Fecal samples were extracted for DNA database construction,and 16S rDNA high-throughput sequencing was used to analyze and compare the intestinal flora and metabolic pathways.Result:①The BMI,fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 h PBG),total cholestero(l TC),triglycerid(e TG),low density lipoprotein(LDL),FINS,FCP,and HOMA-IR were higher in patients with DHTS syndrome than in patients with QYD syndrome,and the high density lipoprotein(HDL)of the former was lower than that of the latter,(P<0.05,P<0.01).②In terms of species composition and differences,Bacteroidetes,Clostridia and Gammaproteobacteria were dominant at the class level,and the relative abundance of Clostridia,Mollicutes and Verrucomicrobiae in QYD syndrome group was higher than that in DHTS syndrome group.At the order level,Bacteroidales,Clostridiales and Enterobacteriales were mainly found.The relative abundance of Clostridiales,Erysipelotrichales and Verrucomicrobiales in QYD syndrome group was obviously higher than that in DHTS syndrome group,while Aeromonadales in the former was lower than that in the latter(P<0.05).At the family level,Bacteroidaceae,Prevotellaceae and Ruminococcaceae were predominant.The relative abundance of Ruminococcaceae,Porphyromonadaceae and Erysipelotrichaceae in QYD syndrome group was higher than that in DHTS syndrome group(P<0.
作者
冉颖卓
邵鑫
胡钢
陆源源
李鸣
沈宝华
孔文文
官艳华
杨鑫
方家
刘晶
RAN Ying-zhuo;SHAO Xin;HU gang;LU Yuan-yuan;LI Ming;SHEN Bao-hua;KONG Wen-wen;GUAN Yan-hua;YANG Xin;FANG Jia;LIU Jing(Nanjing Hospital of Chinese Medicine,Nanjing 210012,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第2期139-146,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
江苏省重点研发计划(社会发展)项目(BE2017618)
南京市中医药青年人才项目(2020-NJSZYYQNRC-SX)
冉颖卓南京市名中医工作室。
关键词
2型糖尿病
湿热困脾证
气阴两虚证
肠道菌群
16S
rDNA高通量测序
type 2 diabetes mellitus
dampness heat trapping spleen syndrome
Qi-Yin deficiency syndrome
intestinal flora
16S rDNA high-throughput sequencing
