女性Ⅱ型糖尿病患者尿液菌群特征与非感染性下尿路症状的关系

Relationship between characteristics of urinary microbiome and non-infectious lower urinary tract symptoms in female type Ⅱ diabetic patients

目的:比较出现非感染性下尿路症状(non-infectious lower urinary tract symptoms,non-iLUTS)对女性Ⅱ型糖尿病(diabetes mellitus,DM)患者尿液菌群的影响,探讨该类患者潜在的菌属标志物。方法:确诊为Ⅱ型DM的女性患者纳入DM组,同期健康女性纳入对照组。两组均完成美国泌尿科协会症状指数问卷(American Urological Association Symptom Index Questionnaire,AUA-SI)。样本通过清洁中段尿的方法留取并进行DNA提取。Illumina测序平台进行扩增和高通量测序。原始数据导入QIIME分析样本微生物的α和β多样性。LEfSe分析不同分组间属水平上具有显著差异的细菌。结果:DM组和对照组剔除序列数过少的参与者后分别为19例和20例,除了体重指数外,两组的人口学特征差异无统计学意义(P>0.05)。DM组尿液菌群的Chao1指数和Observed species低于对照组(P<0.01),提示DM组菌群丰富度低于对照组;香农和辛普森指数提示两组菌群多样性差异无统计学意义(P>0.05);β多样性提示两组菌群结构差异有统计学意义(P<0.01);LEfSe提示DM组有3个菌属的相对丰度升高,9个菌属的相对丰度下降。DM伴下尿路症状组尿液菌群中有6个菌属相对丰度显著高于不伴下尿路症状组,两组的α和β多样性差异均无统计学意义(P>0.05)。结论:女性DM患者与健康女性的尿液菌群结构存在显著差异,当女性DM患者出现non-iLUTS时,尿液菌群进一步发生改变。

Objective：To compare the difference of urinary microbiome between typeⅡ diabetic women with non-infectious lower urinary tract symptoms（non-iLUTS）and without of that and to explore the potential biomarkers when diabetic women suffering from this disorder.Method：Women that diagnosed with typeⅡdiabetes mellitus（DM）and healthy female volunteers were recruited and asked to finish the American Urological Association Symptom Index questionnaire（AUA-SI）.Urine specimens were collected from clean catch midstream urine and processed for extracting DNA.Microbial diversity and composition were analyzed using the Illumina sequencing platform targeting to 16 SrDNA gene.Sequencing reads were processed by QIIME.Genus that had difference in relative abundance among groups were identified by LEfSe algorithm.Result：After screening,19 and 20 participants were enrolled in DM group and control group respectively.There was no significant difference in demographic characteristics between DM group and control group except Body Mass Index（P0.05）.Chao1 index and Observed species in DM group were lower than those in control group,which indicated that richness of microbiome was lower in DM group（P0.01）.No significant statistic difference was found between these two groups in Shannon and Simpson index,which indicated that no difference about bacterial diversity was found between these two groups（P0.05）.β-diversity showed that significant difference of bacterial composition was found between these two group（P0.01）.Among the urinary microbiome in DM group,three bacteria＇s relative abundance increased while nine bacteria＇s relative abundance decreased.There was no significant difference inα-diversity andβ-diversity between DM with lower urinary tract symptom group and DM without lower urinary tract symptom group（P0.05）.Among the urinary microbiome in DM with lower urinary tract symptom group,six bacteria＇s relative abundance increased.Conclusion：Significant difference was found in the component of urinary microbiome between female diabetic patients and healthy controls.The urinary microbiome further changed when female diabetic patients suffering from non-iLUTS.