女性2型糖尿病患者尿液细菌分布及其与血清IL-6的相关性

Diversity of urine bacteria in female type 2diabetes mellitus patients and its correlation with serum IL-6

目的检测女性2型糖尿病(T2DM)患者尿液细菌多样性特征,分析其与白细胞介素-6(IL-6)水平的相关性。方法选择2016年1月至2019年6月于本院诊治的女性T2DM患者60例作为T2DM组。选择同期于本院行尿液细菌检测的健康女性60例作为健康组。收集两组对象尿液样本,采用细菌DNA测序法对样本内细菌16SrRNA-cDNA高可变区进行测序,比较两组对象尿液细菌分布特征。采用ELISA法测定血清IL-6水平,根据IL-6检出情况分为IL-6组和非IL-6组,比较两组对象尿液细菌的组成情况及其与IL-6的关系。结果T2DM组患者尿液微生物多样性、Shannon指数、谱系多样性、菌种丰富度指数均低于健康组(均P<0.05)。共发现35个细菌门,其中T2DM组33个,健康组35个。T2DM组患者相对丰度较多的细菌为变形菌门(50.77%)、拟杆菌门(21.62%)和厚壁菌门(14.46%)。健康组相对丰度较多的细菌为变形菌门(54.49%)、拟杆菌门(22.81%)和厚壁菌门(10.02%)。T2DM组患者尿液中绿弯菌门、硝化螺旋菌门、疣微菌门相对丰度均低于健康组(均P<0.05),其他菌门差异无统计学意义(均P>0.05)。共发现438个细菌属,其中T2DM组438个,健康组421个。T2DM组和健康组共有30个菌属水平差异有统计学意义(均P<0.05)。IL-6组和非IL-6组患者尿液微生物多样性、Shannon指数、谱系多样性、菌种丰富度指数比较差异均无统计学意义(均P>0.05)。多元回归分析显示,共有15种细菌属与血清IL-6水平有线性相关关系。结论女性T2DM患者尿液菌群紊乱且与IL-6互为影响,应关注患者尿液菌群和膀胱炎症情况。

Objective To explore the diversity of urine bacteria in female patients with type 2diabetes mellitus(T2DM)and its correlation with serum interleukin-6(IL-6).Methods A total of 60T2DM women(T2DM group)and 60healthy women(Control group)in our hospital from January 2016to June 2019were enrolled.Bacterial DNA was extracted,and variable regions of the 16SrRNA-cDNA were amplified.The diversity and structures of urine bacteria were compared between the two groups.The level of serum IL-6 was determined with ELISA.The patients were further divided into IL-6group and non-IL-6group according to the presence or absence of IL-6.The relative abundance of urine microecological bacteria was compared between the two groups,and multiple stepwise regression analysis was performed to determine the bacteria related to the changes in IL-6level.Results The microbial diversity,shannon index,pedigree diversity and species richness index in T2DM group were lower than those in control group respectively(all P<0.05).A total of 35bacterial phyla were found,including 33in the T2DM group and 30in the control group.The bacterial phyla with higher relative abundance were Proteobacteria(50.77%),Firmicutes(21.62%)and Bacteroidetes(14.46%)in T2DM group,and Proteobacteria(54.49%),Firmicutes(22.81%)and Bacteroidetes(10.02%)in control group.The relative abundances of Chloroflexi,Nitrospirae and Verrucomicrobia in the T2DM group were lower than those in the control group(all P<0.05);there wee no significant differences in other phyla(all P>0.05).A total of 438bacterial genera were found,including 438in the T2DM group,and 421in the control group.There were statistically significant differences in the levels of 33bacterial genera between the two groups(all P<0.05).The detection rate of IL-6in T2DM patients was 68.33%(41/60),and the level was(63.25±11.20)pg/mL.The microbial diversity,shannon index,pedigree diversity and bacterial species richness index had no significant differences between IL-6group and non-IL-6group(all P>0.05).Multiple stepwise regression analysis showed that 15bacterial genera had a linear correlation with IL-6level(P<0.05).Conclusion The urine floral disorder and IL-6 level in female T2DM patients interact with each other;the microecology and bladder inflammation of patients should be closely observed.