肠道菌群介导的免疫状态改变在二甲双胍治疗糖尿病中的作用研究

The role of intestinal flora mediated changes in immune status in the treatment of diabetes mellitus with metformin

目的探讨肠道菌群介导的免疫状态改变在二甲双胍治疗糖尿病中的作用。方法选取本院2017年6月至2020年1月收治的2型糖尿病患者90例,所有患者均给予肠道菌群检测,并给予二甲双胍治疗,治疗2、4周后记录肠道菌群的丰度及免疫状态,比较双歧杆菌、大肠埃希菌丰度明显增加组与变化不明显组的免疫指标(血清IgM、IgA、IgG、C3及C4),分析肠道菌群介导的免疫状态改变在二甲双胍治疗糖尿病中的作用。结果治疗2、4周后,患者大肠埃希菌、双歧杆菌和乳杆菌均明显高于治疗前,其中治疗4周后大肠埃希菌、双歧杆菌丰度与治疗前和治疗2周后比较差均有统计学意义(P<0.05)。治疗4周后,肠道菌群丰度增加组血清IgM、IgA、IgG、C3及C4明显高于变化不明显组,差异均有统计学意义(P<0.05)。结论二甲双胍可明显改善2型糖尿病患者的肠道菌群,其可能是通过调节肠道菌群促进免疫状态的改善,发挥降糖机制。

Objective To investigate the effect of intestinal flora mediated changes in immune status in the treatment of diabetes mellitus with metformin.Methods 90 cases of type 2 diabetes mellitus patients in our hospital from June 2017 to January 2020,all patients were given detection of intestinal flora.The abundance and immune status of intestinal flora were recorded 2 and 4 weeks after treatment.The immune indexes(serum IgM,IgA,IgG,C3 and C4)between the increased bifidobacteria and Escherichia coli abundance group were compared with the non-significant change group,and the role of intestinal flora mediated immune state change in the treatment of diabetes with metformin was analyzed.Results After 2 and 4 weeks of treatment,Escherichia coli,Bifidobacteria and Lactobacillus were significantly higher than before treatment,and the abundance of Escherichia coli and Bifidobacteria after 4 weeks of treatment was significantly lower than that before and after 2 weeks of treatment(P<0.05).After 4 weeks of treatment,serum IgM,IgA,IgG,C3 and C4 in the increased intestinal flora abundance group were significantly higher than those the no obvious change group,the difference was statistically significant(P<0.05).Conclusion Metformin can significantly improve the intestinal flora of patients with type 2 diabetes mellitus,which may be through the regulation of intestinal flora to promote the improvement of immune status and play hypoglycemic mechanism..