炎症性肠病患者维生素D水平与肠道菌群的相关性

Correlation between Vitamin D Status and Gut Microbiota in Patients with Inflammatory Bowel Disease

目的探讨炎症性肠病(IBD)患者血清总25羟维生素D[T-25(OH)D]水平与粪便菌群结构之间的关系。方法收集23例IBD患者临床资料并采集新鲜粪便行16S rDNA V4区域扩增子测序分析,根据血清T-25(OH)D水平分为维生素D正常组(n=5)、维生素D不足组(n=5)和维生素D缺乏组(n=13),分析3组IBD患者粪便菌群构成的差异。结果3组IBD患者的粪便菌群Alpha多样性、Beta多样性无差异。三元图分析显示变形菌门丰度在维生素D缺乏组最高,放线菌门丰度在维生素D正常组最高。Spearman相关性分析显示,在门水平:血清T-25(OH)D水平与变形菌门丰度呈负相关(r=-0.445,P=0.033),与放线菌门丰度呈正相关(r=0.447,P=0.033);科水平:血清T-25(OH)D水平与毛螺菌科(r=0.414,P=0.049)、双歧杆菌科(r=0.468,P=0.024)、Erysipelotrichaceae(r=0.584,P=0.003)和埃格特菌科(r=0.507,P=0.014)的丰度呈正相关,与气球菌科(r=-0.514,P=0.012)的丰度呈负相关;属水平:血清T-25(OH)D水平与布劳特氏菌属(r=0.459,P=0.028)、双歧杆菌属(r=0.468,P=0.024)、未分类Erysipelotrichacea(r=0.485,P=0.019)、Faecalitalea(r=0.544,P=0.007)、Anaerostipes(r=0.475,P=0.022)、Romboutsia(r=0.510,P=0.013)、Flavonifractor(r=0.455,P=0.029)和Erysipelatoclostridium(r=0.617,P=0.002)的丰度呈正相关。结论不同血清T-25(OH)D水平的IBD患者粪便菌群构成发生改变,维生素D缺乏组较维生素D正常组变形菌门丰度明显增高、放线菌门丰度明显下降。血清T-25(OH)D水平与变形菌门等有害菌的丰度呈负相关,而与毛螺菌科、双歧杆菌科、丁酸弧菌等益生菌的丰度呈正相关。

Objective To investigate the correlation between serum total 25-hydroxyvitamin D[T-25(OH)D]level and fecal microbiota in patients with inflammatory bowel disease(IBD).Methods Twenty-three patients with IBD completed the tests for serum T-25(OH)D,and the fecal microbiota was studied using V4 hypervariable region of 16S ribosomal RNA(rRNA)gene sequencing.According to serum T-25(OH)D level,the patients were divided into three groups including vitamin D normal group(n=5),vitamin D insufficiency group(n=5),and vitamin D deficiency group(n=13).Results There was no significant difference between these three groups in Alpha diversity or Beta diversity.Ternary pot at phylum level revealed that the abundance of Proteobacteria was the highest in the vitamin D deficiency group and Actinomycete was the highest in the vitamin D sufficiency group.Spearman correlation analysis showed that at the phylum level serum T-25(OH)D level was negatively correlated with the abundance of Proteobacteria(r=-0.445,P=0.033)and positively correlated with the abundance of Actinomycetes(r=0.447,P=0.033);at family level it was positively correlated with the abundance of Lachnospiraceae(r=0.414,P=0.049),Bifidobacteriaceae(r=0.468,P=0.024),Erysipelotrichacea(r=0.584,P=0.003),and Eggerthellaceae(r=0.507,P=0.014)and negatively correlated with the abundance of Aerococcaceae(r=-0.514,P=0.012);and at genus level it was positively correlated with the abundance of Blautia(r=0.459,P=0.028),Bifidobacterium(r=0.468,P=0.024),unidentified Erysipelotrichacea(r=0.485,P=0.019),Faecalitalea(r=0.544,P=0.007),Anaerostipes(r=0.475,P=0.022),Romboutsia(r=0.510,P=0.013),Flavonifractor(r=0.455,P=0.029),and Erysipelatoclostridium(r=0.617,P=0.002).Conclusions The fecal microbiota composition varies in IBD patients with different serum T-25(OH)D levels.The abundance of Proteobacteria increases and the abundance of Actinomyces decreases in IBD patients with vitamin D deficiency compared with IBD patients with normal vitamin D level.Serum T-25(OH)D level is negatively correlated with the abundance of some harmful bacteria(e.g.Proteobacteria)but is positively correlated with the abundance of some probiotics such as Lachnospiraceae,Bifidobacteriaceae,and Anaerostipes.