老年2型糖尿病早期肾病患者肠道菌群多样性

Intestinal microflora diversity in elderly T2DM patients with early nephropathy

目的探讨老年2型糖尿病早期肾病患者肠道菌群的多样性。方法选取2018年1月至2019年10月我院收治的47例2型糖尿病早期肾脏并发症患者(糖尿病肾病组)和53例2型糖尿病无并发症患者(2型糖尿病组)作为研究对象,另将同期在我院行体检的42例健康者作为对照组,采集3组对象粪便标本,提取并扩增粪便样本中细菌的16S rDNA,利用高通量测序技术对16S rDNA进行测序,进行可操作分类单元(OTU)划分,并对比分析各样本的Alpha多样性及菌群门类组成。结果糖尿病肾病组独有的OTU有441个,2型糖尿病组独有的OTU有708个,对照组独有的OTU有559个,3组共有的OTU有1 847个。3组对象肠道菌群Ace、Chao1、Simpson和Shannon等指数相比差异均无统计学意义(均P>0.05)。糖尿病肾病组、2型糖尿病组、对照组对象肠道菌群Ace指数和Chao1指数依次升高,糖尿病肾病组和2型糖尿病组患者Simpson指数和Shannon指数均低于对照组(均P<0.05)。3组对象肠道菌群主要组成门类为厚壁菌门、变形菌门、放线菌门和拟杆菌门。糖尿病肾病组、2型糖尿病组、对照组对象肠道厚壁菌门与拟杆菌门的比值依次升高。结论老年2型糖尿病早期肾病患者的肠道菌群多样性下降,肠道菌群失调可能与2型糖尿病肾病的发生发展存在一定的关系。

Objective To explore the diversity of intestinal flora in elderly patients with early type 2 diabetic nephropathy. Methods A total of 47 patients with early renal complications of type 2 diabetes mellitus(T2 DM)(diabetic nephropathy group) and 53 patients without complications of T2 DM(type 2 diabetes group) from January 2018 to October 2019 were selected as the subjects, with 42 healthy individuals who received physical examination in our hospital at the same time as the control group. The fecal samples were collected;16 S rDNA of bacteria in fecal samples was extracted and amplified, and sequenced by using high-throughput sequencing technology;the OTUs were divided, and alpha diversity and floral composition were compared and analyzed. Results There were 441 unique OTUs in diabetic nephropathy group, 708 unique OTUs in type 2 diabetes group, 559 unique OTUs in control group and 1,847 shared OTUs in the three groups. There were no significant differences among the three groups in alpha diversity indexes Ace, Chao1, Simpson and Shannon index(all P>0.05). The Ace index and Chao1 index increased in turn in the diabetic nephropathy group, type 2 diabetes group and control group. The Simpson index and Shannon index in the diabetic nephropathy group and type 2 diabetes group were lower than in the control group, respectively(all P<0.05). The intestinal flora in the three groups were mainly composed of Firmicutes, Proteobacteria, Actinobacteria and Bacteroidetes. The ratio of Firmicutes to Bacteroidetes in diabetic nephropathy group, type 2 diabetes group and control group increased in turn. Conclusion The diversity of intestinal flora in elderly patients with early type 2 diabetic nephropathy decreased, and the imbalance of intestinal flora may be related to the occurrence and development of type 2 diabetic nephropathy.