2型糖尿病患者肠道菌群变化及意义

摘要

目的 探讨2型糖尿病(T2DM)患者肠道菌群变化的临床意义.方法 选取8例T2DM患者与10例体检健康者,提取其粪便基因组DNA,应用菌属16S rRNA V4序列特异性引物,采用高通量测序技术分析肠道菌群多样性(以香农多样性指数表示)及种类(以丰度表示).观察不同性别T2DM患者的肠道菌群种类差异,分析T2DM患者肠道优势菌属与空腹血糖(FPG)、餐后1 h血糖(1 h PG)和餐后2 h血糖(2 h PG)的关系.结果 T2DM患者与体检健康者香农多样性指数分别为3.70±0.29、3.30±0.20,二者比较P>0.05.门水平下T2DM患者和体检健康者的肠道共同优势菌门为厚壁菌门、拟杆菌门、变形菌门和放线菌门,二者上述4种优势菌门丰度比较差异均无统计学意义(P均>0.05).属水平下T2DM患者和体检健康者的肠道共同优势菌属为拟杆菌属和毛螺杆菌科,体检健康者罗斯氏菌属丰度高于T2DM患者(P<0.05).女性T2DM患者拟杆菌属科丰度高于男性患者,假单胞菌属丰度低于男性患者(P均<0.05).T2DM患者柔嫩梭菌属丰度与2 h PG呈正相关(r=0.75,P<0.05),其他肠道优势菌属与FPG、1 h PG、2 h PG均无关(P均>0.05).结论 T2DM患者肠道内存在菌群失调,并具有性别差异;柔嫩梭菌属与血糖水平有关,可为T2DM的治疗提供一种新的思路.%Objective To detect the variation of intestinal flora in patients with type 2 diabetes mellitus (T2DM) and the clinical significance.Methods The fecal samples were collected from 8 T2DM patients and 10 healthy participants.Total DNA was extracted from stool samples and submitted to high-throughput sequencing with primers targeting V4 region of the 16s rRNA gene.High-throughput sequencing was used to analyze the abundance and diversity of fecal microbiota.The difference of intestinal flora in patients with different gender, and the relationship between the dominant bacteria in the T2DM patients and fasting plasma glucose (FPG), 1 hour postprandial blood glucose (1h PG) and 2 hour postprandial blood glucose (2h PG) were investigated.Results The Shannon diversity index of T2DM patients and healthy subjects was 3.70±0.29 and 3.30±0.20, respectively, and there was no significant difference between the two groups (P>0.05).The dominant bacteria in the two groups were Firmicutes, Bacteroides, Proteobacteria, Actinobacteria at phylum level, and there was no significant difference in the abundance between the two groups (all P>0.05).In addition, the dominant bacteria were Bacteroides and Lachnospiraceae in the two groups at genus level.Compared with healthy subjects, the abundance of Roseburia was significantly reduced in the T2DM patients (P<0.05).The abundance of the Bacteroides in the female T2DM patients was much higher than that of the male patients, while the abundance of Peptostreptococcaceae was much lower than that of the male patients (P<0.05).The abundance of Faecalibacterium was positively correlated with 2 h PG (r=0.75, P<0.05), and the other dominant bacteria were not correlated with FPG, 1 h PG, 2 h PG (all P>0.05).Conclusion T2DM patients show intestinal flora imbalance with gender differences, and the abundance of Faecalibacterium in T2DM patients is related to blood glucose, which may provide a new therapeutic approach for T2DM.