2型糖尿病患者角膜神经病变与眼表菌群相关性的研究

Correlation between corneal neuropathy and ocular surface flora in type 2 diabetes

目的探讨2型糖尿病患者角膜神经病变和眼表菌群的变化以及角膜神经病变与眼表菌群变化的相关性。方法根据眼底荧光血管造影术结果,选取2019年3月至6月于河南省人民医院内分泌科就诊的单纯应用胰岛素治疗的不合并视网膜病变2型糖尿病患者65例(共130眼)、年龄匹配的糖耐量正常人群65名(共130眼)为研究对象,进行共聚焦显微镜检查并收集结膜囊分泌物,通过16S rRNA分析测序及PICRUSt菌群基因功能预测,探究2型糖尿病患者与健康人角膜神经病变程度和眼表菌群构成的差异及功能预测,同时分析角膜神经病变与眼表菌群的相关性。结果与健康人群相比,2型糖尿病患者角膜神经病变程度更高,且与眼表菌群变化有关。短芽孢杆菌属、类芽孢菌属与角膜神经病变程度呈正相关(P<0.05),栖水菌属、变形菌属与角膜神经病变程度呈负相关(P<0.05)。PICRUSt分析显示,2型糖尿病患者和健康人群相比,眼表菌群的代谢相关基因富集程度发生显著的变化。结论2型糖尿病患者角膜神经病变程度高,眼表菌群多样性及代谢功能有显著变化,角膜神经病变程度与短芽孢杆菌属、类芽孢菌属、栖水菌属、变形菌属有关。

Objective To explore the changes of corneal neuropathy and ocular surface flora in patients with type 2 diabetes,and the correlation between corneal neuropathy and ocular surface flora changes.Methods According to the results of fundus fluorescein angiography,65 patients with type 2 diabetes(130 eyes in total)who were treated with insulin alone and without comorbid retinopathy in the Department of Endocrinology,Henan People′s Hospital from March to June 2019 were selected.Sixty-five age-matched normal glucose tolerance subjects(130 eyes in total)were also enrolled.Confocal microscopy was performed and conjunctival sac secretions were collected.Through 16S rRNA analysis and sequencing and PICRUSt bacterial gene function prediction,the relationship between patients with type 2 diabetes and the difference in the degree of corneal neuropathy and the composition of ocular surface flora and function prediction in healthy people were explored,and the correlation between corneal neuropathy and ocular surface flora was analyzed as well.Results Compared with healthy people,patients with type 2 diabetes have more severe corneal neuropathy,and it was related to the changes in ocular surface flora.Brevibacillus and paenibacillus were significantly positively correlated with the degree of corneal neuropathy(P<0.05),and enhydrobacter and proteobacteria were significantly negatively correlated with the degree of corneal neuropathy(P<0.05).PICRUSt analysis showed that the degree of enrichment of metabolism-related genes in the ocular surface flora of patients with type 2 diabetes was significantly changed compared with healthy people.Conclusion Patients with type 2 diabetes present with more severe corneal neuropathy.The diversity of ocular surface flora and metabolic function have significant changes.The degree of severity corneal neuropathy is related to brevibacillus,paenibacillus,enhydrobacter,and proteobacteria.