2型糖尿患者肠道菌群特征分析

The intestinal microbiota in type 2 diabetes patients

目的分析2型糖尿病患者与健康志愿者间肠道菌群的差异,分析肠道菌群与空腹血糖之间的关系,探讨肠道细菌在2型糖尿病发生、发展中可能发挥的作用。方法纳入55例2型糖尿病患者(糖尿病组)及57例健康志愿者(对照组),对其粪便提取基因组DNA,应用菌属16srRNA V3序列特异性引物,进行实时荧光定量PCR分析。结果糖尿病组与对照组肠道细菌总数、球形梭菌类群数量、乳酸杆菌属数量、大肠杆菌菌属数量差异无统计学意义(P=0.586、P=0.394、P=0.611、P=0.270);糖尿病组柔嫩梭菌类群、双歧杆菌属、肠球菌属数量较对照组显著增加(P<0.01),拟杆菌属数量较对照组显著减少(P=0.007)。糖尿病组与对照组之间双歧杆菌属、乳酸杆菌属、大肠杆菌属占总细菌比例差异无统计学意义(P=0.094、P=0.642、P=0.231);糖尿病组柔嫩梭菌类群、肠球菌属占总细菌比例较对照组显著增加(P=0.005、P=0.000),拟杆菌属/球形梭菌占总细菌比例较对照组显著性减少(P=0.019)。空腹血糖与肠球菌属数量(r=0.221、P=0.019)、肠球菌属占总细菌比例(r=0.213、P=0.013)呈正相关,与拟杆菌属数量(r=-0.246、P=0.009)、拟杆菌属/球形梭菌占总细菌比例(r=-0.202、P=0.033)呈负相关。结论 2型糖尿病患者肠道内存在菌群失调;应用微生态制剂调节糖尿病患者肠道菌群构成、改善血糖情况,未来可能作为控制2型糖尿病病情、改善预后的一种新治疗策略。

Objective To assess the differences between the compositions of the intestinal microbiota in type 2 diabetes（T2DM） and healthy persons;and thus to investigate the correlation between fast plasma glucose（FPG） and microbiota;furthermore,to study the potential role of intestinal microbiota in the development of T2DM.Methods This study included 55 T2DM patients and 57 healthy participants.Total DNA was extracted from collected stool samples and submitted to real-time quantitative PCR（qPCR） with primers targeting V3 region of the 16srRNA gene.Results There was no significant difference between T2DM patients and controls in total bacteria,Clostridium coccoides,Lactobacillus,Escherichia coli counts（P = 0.586,P = 0.394,P = 0.611,P = 0.270,respectively）.Compare with controls,the Clostridium leptum,Bifidobacterium,Enterococcus counts were significantly increased（P〈0.01）,while Bacteroides significantly reduced（P = 0.07） in T2DM patients.There was no significant difference in Bifidobacterium,Lactobacillus or Escherichia coli proportion between the two groups（P = 0.094,P = 0.642,P = 0.231,respectively）;while in T2DM patients,the proportions of Clostridium leptum and Enterococcus were significantly increased（P = 0.005,P = 0.000,respectively）,as the Bacteroides/Clostridium coccoides proportion significantly reduced（P = 0.019）.Furthermore,the Enterococcus count and proportion were significantly positively correlated with plasma glucose concentration in T2DM patients（P〈0.05）,while the Bacteroides and Bacteroides/Clostridium coccoides counts were significantly negatively correlated with plasma glucose concentration（P = 0.009 and P = 0.033,respectively）.Conclusion T2DM is associated with compositional changes in intestinal microbiota.The modification of intestinal microbiota should be considered in plasma glucose control for T2DM patient.