老年糖尿病患者肠道菌群与糖化血红蛋白的关系

Relationship between intestinal flora and glycosylated hemoglobin in elderly diabetic patients

目的 研究老年2型糖尿病患者肠道菌群的变化,分析肠道菌群与糖化血红蛋白(HbA1c)的关系,为老年2型糖尿病患者血糖控制提供指导。方法 选择2019年1月至2020年1月我院169例老年2型糖尿病患者为研究对象,分为血糖控制良好组(67例,HbA1c<7.0%)及血糖控制不良组(102例,HbA1c≥7.0%),并选择同期83例健康老年志愿者为对照组,采用光冈法检测3组研究对象肠道菌群,分析肠道菌群变化与HbA1c关系。结果 对照组、血糖控制良好组以及血糖控制不良组对象肠道双歧杆菌、乳杆菌、拟杆菌数量依次降低,肠杆菌数量依次升高,任意组间差异均有统计学意义(均P<0.05);但肠球菌数量在3组间差异无统计学意义(均P>0.05)。2型糖尿病患者肠道双歧杆菌、乳杆菌数量与HbA1c水平呈负相关,相关系数分别为-0.431、-0.356,均有统计学意义(均P<0.05)。结论 2型糖尿病与肠道菌群紊乱相互影响,纠正肠道菌群紊乱对于2型糖尿病患者血糖控制有重要意义。

Objective To observe the changes of intestinal flora in elderly patients with type 2 diabetes mellitus(T2DM),and analyze the relationship between intestinal microecology and glycosylated hemoglobin(HbA1c), so as to provide guidance for blood glucose control in elderly patients with T2DM. Methods A total of 169 elderly patients with type T2DM in our hospital from January 2019 to January 2020 were selected as the subjects and divided into well-controlled blood glucose group(67 cases, HbA1c<7.0%) or poorly-controlled blood glucose group(102 cases, HbA1c≥7.0%). 83 healthy elderly volunteers were selected as the control group. The intestinal microflora in the three groups were detected using Mitsuoka method, and the relationship between intestinal flora changes and HbA1c was analyzed. Results Intestinal Bifidobacterium, Lactobacillus and Bacteroides decreased, while the Enterobacter increased in the control group, well-controlled blood glucose group and poorly-controlled blood glucose group in turn. The differences between any two groups were statistically significant(all P<0.05), but there was no significant difference in Enterococcus among the three groups(all P>0.05). Bifidobacterium and Lactobacillus were negatively correlated with HbA1c in patients with T2DM, and the correlation coefficients were-0.431 and-0.356, respectively, with statistical significance(all P<0.05). Conclusion T2DM and intestinal flora disorder affect each other. Correcting intestinal microecological disorder has important clinical significance for blood glucose control in patients with T2DM.