摘要
背景患有妊娠期糖尿病(GDM)的孕妇常合并妊娠期高血压疾病(HDP),进而严重影响妊娠期健康及分娩结局。肠道菌群与妊娠健康关系受到越来越多的关注,但其与GDM合并HDP的关联还有待研究。目的探究GDM患者肠道菌群特征与并发HDP的关联。方法以2019年8月—2020年1月在杭州市妇产科医院行产前检查的204例GDM患者为研究对象。仅确诊GDM的孕妇作为GDM组(n=181),同时确诊GDM和HDP的孕妇作为GDM合并HDP组(n=23)。收集入组孕妇的临床资料与炎症检测指标,并留取同期粪便样本进行肠道菌群16S rDNA扩增子测序分析;采用LEfSe分析,在门、科和属水平分别对两组孕妇肠道菌群的组成结构进行比较,识别各组明显富集的菌群;通过Logistic回归分析探索GDM合并HDP相关的肠道菌群特征;采用Spearman秩相关分析探究肠道菌群与炎症指标的关联。结果两组肠道菌群组成及主要门水平上的菌群相对丰度比较,差异无统计学意义(P>0.05)。LEfSe分析结果:科水平分析显示,与GDM组相比,韦荣氏菌科(Veillonellaceae)在GDM合并HDP组明显富集(P<0.05),而柔膜菌纲RF39未分类菌科(Mollicutes RF39 unclassified family)和毛螺菌科(Lachnospiraceae)的相对丰度降低(P<0.05);属水平分析显示,与GDM组相比,小杆菌属(Dialister)、肠杆菌属(Intestinibacter)、真杆菌属(Eubacterium)和副萨特氏菌属(Parasutterella)在GDM合并HDP组明显富集(P<0.05);与GDM合并HDP组相比,嗜木聚糖真杆菌属([Eubacterium]xylanophilum group)、Ruminiclostridium 6、柔膜菌纲RF39未分类菌属(Mollicutes RF39 unclassified genus)和毛螺菌科未分类菌属(Lachnospiraceae unclassified genus)在GDM组明显富集(P<0.05)。Logistic回归分析结果显示,Veillonellaceae(OR=1.06,95%CI=1.01~1.11)、Dialister(OR=1.26,95%CI=1.10~1.45)、Intestinibacter(OR=2.07,95%CI=1.12~3.84)丰度上升是GDM孕妇合并HDP的独立危险因素(P<0.05);Lachnospiraceae unclassified genus(OR=0.24,95%CI=0.08~0.7
Background Pregnant women with gestational diabetes mellitus(GDM)are often comorbid with hypertensive disorders of pregnancy(HDP),which can severely impact pregnancy health and delivery outcomes.The relationship between gut microbiota and pregnancy health has received increasing attention,but its association with concurrent HDP in GDM remains to be investigated.Objective To explore the association between gut microbiota characteristics and concurrent HDP in GDM patients.Methods The 204 patients with GDM who underwent prenatal examination at the Hangzhou Women's Hospital from August 2019 to January 2020 were selected as the study subjects.Pregnant women diagnosed with GDM only were categorized as the GDM group(n=181),while those concurrently diagnosed with GDM and HDP were categorized as the GDM with concurrent HDP group(n=23).Clinical data and inflammation detection markers of the enrolled pregnant women were collected,and fecal samples of the same period were retained for gut microbiota 16S rDNA amplicon sequencing analysis.LEfSe analysis was used to compare microbiota composition between the two groups at the phylum,family and genus levels,and to identify distinct bacterial enrichments.Logistic regression analysis was performed to identify gut microbiota characteristics associated with concurrent HDP in GDM.Spearman's rank correlation analysis was performed to explore the association between gut microbiota and inflammatory markers.Results No significant differences were found in overall gut microbiota composition and relative abundances of major phyla between the two groups(P>0.05).LEfSe analysis on family level showed that the Veillonellaceae family was enriched in the GDM with concurrent HDP group(P<0.05),while Mollicutes RF39 unclassified family and Lachnospiraceae were depleted(P<0.05).At the genus level,Dialister,Intestinibacter,Eubacterium and Parasutterella were enriched in the GDM with concurrent HDP group(P<0.05),whereas[Eubacterium]xylanophilum group,Ruminiclostridium 6,Mollicutes RF39 unclassified ge
作者
代愉恒
高畅
梁新袖
卢莎
华雯
郑钜圣
胡文胜
DAI Yuheng;GAO Chang;LIANG Xinxiu;LU Sha;HUA Wen;ZHENG Jusheng;HU Wensheng(Hangzhou Women's Hospital,Hangzhou 310008,China;School of Life Sciences,Westlake University,Hangzhou 310024,China;The Affiliated Hangzhou Women's Hospital of Hangzhou Normal University,Hangzhou 310008,China;The Fourth Clinical School of Zhejiang Chinese Medicine University,Hangzhou 310053,China)
出处
《中国全科医学》
北大核心
2024年第2期156-162,共7页
Chinese General Practice
基金
国家自然科学基金面上项目(82173530)
浙江省科学技术厅“尖兵”“领雁”研发攻关计划项目(2022C03102)
浙江省自然科学基金(LQ21H040001)。
关键词
糖尿病
妊娠
高血压
妊娠性
肠道菌群
LEfSe分析
炎症
影响因素分析
Diabetes,gestational
Hypertension,pregnancy-induced
Intestinal flora
LEfSe analysis
Inflammation
Root cause analysis
