妊娠糖尿病患者肠道菌群与血糖水平的相关性分析

Correlation analysis of intestinal microflora and blood glucose level in patients with gestational diabetes mellitus

目的探讨妊娠糖尿病(GDM)患者粪便中双歧杆菌和乳酸杆菌的变化及其与血糖水平的相关性。方法选择2017年1月至2018年12月到该院妇产科门诊进行产前检查并建档确诊为GDM的患者50例为GDM组,选择同期50例与GDM组在年龄方面无显著差异且糖耐量正常的妊娠妇女为对照组,所有受试者均为单胎妊娠。收集所有研究对象孕29周时的血液与粪便,采用全自动生化分析仪检测临床生化指标,荧光定量PCR法检测肠道菌群双歧杆菌和乳酸杆菌的数量。比较两组间双歧杆菌和乳酸杆菌数量的差异,分析其与空腹血糖(FBG)的相关性。结果 GDM组的血脂指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]及FBG水平均高于对照组,但高密度脂蛋白胆固醇(HDL-C)水平明显低于对照组,差异均有统计学意义(P<0.05);GDM组的肠道双歧杆菌及乳酸杆菌数量均低于对照组,差异有统计学意义(P<0.05),进一步研究发现,双歧杆菌及乳酸杆菌数量与FBG呈负相关。结论 GDM患者双歧杆菌和乳酸杆菌数量减少,推测双歧杆菌和乳酸杆菌在GDM的发生、发展中有一定作用。

Objective To investigate the changes of bifidobacterium and lactobacillus in feces of the patients with gestational diabetes mellitus(GDM)and their correlation with blood glucose level.Methods Fifty pregnant women with GDM in the obstetrics and gynecology out-patient department of the hospital from January 2017 to December 2018,who conducted the prenatal examination and established the archive,were selected as the GDM group,contemporaneous 50 normal pregnant women with normal glucose tolerance and without significant difference in age compared with the GDM group were selected as the control group.All subjects were singleton pregnancy.The blood and feces of all subjects were collected at 29 weeks of gestation.The clinical biochemical indexes were detected by adopting the automatic biochemical analyzer,and the numbers of bifidobacterium and lactobacillus in intestinal tract were detected by fluorescence quantitative PCR(FQPCR).The differences of bifidobacterium and lactobacillus numbers were compared between the two groups,and their correlation with fasting blood glucose was analyzed.Results The levels of TG,TC,LDL-C and FBG in the GDM group were higher than those in the control group,but the HDL-C level was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).The numbers of intestinal bifidobacterium and lactobacillus in the GDM group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The further study found that the numbers of bifidobacterium and lactobacillus were negatively correlated with fasting blood glucose.Conclusion The numbers of bifidobacterium and lactobacillus in the patients with GDM is decreased.It is speculated that bifidobacterium and lactobacillus play a certain role in the occurrence and development of GDM.