肥胖2型糖尿病患者胃旁路术后肠道菌群的变化

Structural changes of gut microbiota after gastric bypass in obese patients with type 2 diabetes

目的基于16S rRNA基因测序技术研究肥胖2型糖尿病患者(BMI≥40 kg/m2)胃旁路术后肠道菌群的结构及代谢变化。方法分别按照胃旁路术前、后两个组收集4位患者粪便样本共计8例,提取细菌总DNA,通过16S rRNA测序研究两组患者间的肠道菌多样性;同时每3月收集手术后患者血清,分析糖代谢和脂代谢变化,以及统计BMI、腰臀比变化。结果通过胃旁路术后,患者的BMI、腰臀比、糖代谢和脂代谢均下降,逐渐趋于正常水平;同时其肠道菌中的拟杆菌门(Bacteroidetes)比例增加,厚壁菌门(Firmicutes)和变形菌门(Proteobacteria)比例减少。结论胃旁路术能有效改善肥胖2型糖尿病患者的病情,同时可改善患者肠道菌的组成。

Objective To investigate the structural changes inintestinal flora and metabolic changes in type 2 diabetic patients with obesity（BMI≥40 kg/m^2）by sequencing the 16S rRNA genes.Methods Stool samples were collected from 4 diabetic patients before and after gastric bypass surgery for extraction of the total DNA.The diversity of the intestinal flora in the samples was investigated by 16S rRNA sequencing.After surgery,the changes in glucose and lipid metabolism were evaluated in the patients,and the changesin body mass index（BMI） and waist-to-hip ratio were assessed at 3-month intervals.Results After gastric bypass,the patient＇s BMI,waist-to-hip ratio,glucose metabolism and lipid metabolism gradually recovered the normal levels.The proportion of Bacteroidetesis increased and the proportions of Firmicutes and Proteobacteria decreased in the intestinal bacteria after the surgery.Conclusion Gastric bypass surgery can effectively alleviate the condition of obese patients with type 2 diabetes and improve the composition of the intestinal flora.