妊娠期糖尿病孕妇肠道菌群变化及其与血糖的相关性

Changes of intestinal flora in pregnant women with gestational diabetes mellitus and its correlation with blood glucose

目的利用16S rDNA高通量测序技术,研究妊娠期糖尿病(GDM)孕妇的肠道菌群变化及与血糖的相关性。方法2020年9月—2021年3月,选取在温州市人民医院定期产前检查并分娩的孕妇44例,根据妊娠24~28周口服75 g葡萄糖耐量试验结果分为妊娠期糖尿病组(22例)及正常对照组(22例),收集孕妇的一般资料。通过Illumina Miseq平台对受试者粪便细菌DNA进行16S rDNA测序,比较两组肠道菌群的结构、丰度及多样性。结果肠道菌群ɑ-多样性分析结果显示,GDM组孕妇Chao1、Shannon、Ace、Coverage指数与正常对照组相比,差异无统计学意义(P>0.05)。两组孕妇肠道菌群的共同优势菌群为厚壁菌门和拟杆菌门,GDM组弯曲杆菌门比例高于对照组(P<0.05)。LEfSe分析结果显示两组丰度有显著差异的物种共有28种,其中24种在GDM组中富集,4种在正常对照组中富集。通过Bray-Curtis dbRDA分析发现,肠道菌群结构与75 g OGTT 0 h血糖及75 g OGTT 1 h血糖呈负相关(P<0.05)。采用Spearman相关性分析评估两组肠道菌群与OGTT血糖值的相关性,发现瘤胃球菌属、链球菌属、丁酸球菌属与OGTT 0 h血糖呈负相关(P<0.05);小杆菌属、布劳特菌属、Monoglobus与OGTT 1 h血糖呈负相关(P<0.05);毛螺旋菌属、普雷沃菌属与OGTT 2 h血糖呈负相关(P<0.05)。结论16S rDNA高通量测序有助于分析GDM孕妇肠道菌群的丰度及多样性,为研究GDM孕妇肠道菌群结构的特点及与血糖的相关性提供新的思路和理论依据。

Objective To observe the changes of intestinal flora of pregnant women with gestational diabetes mellitus and explore its correlation with blood glucose based on 16S rDNA high-throughput sequencing.Methods A total of 44 pregnant women who received antenatal care and delivered in our hospital from September 2020 to March 2021 were enrolled.According to the results of oral 75 g glucose tolerance test at 24 to 28 weeks of pregnancy,they were divided into gestational diabetes group(22 cases)or normal control group(22 cases).16S rDNA high-throughput sequencing was used to observe the changes of intestinal flora.Results Alpha-diversity analysis showed that there were no statistically significant differences in the indexes of Chao1,Shannon,Ace,and Coverage between the two groups(P>0.05).At the phylum level,the dominant flora in the two groups were Firmicutes and Bacteroidota;the proportion of Campilobacterota in the GDM group was higher than that in the control group(P<0.05).LEfSe difference analysis showed that there were 28 species with significant differences in abundance between the two groups,of which 24 species were enriched in the GDM group and 4 species in the normal control group.Bray-Curtis dbRDA analysis demonstrated that the intestinal flora community structure was negatively correlated with 75 g OGTT 0 h and OGTT 1 h blood glucose(P<0.05).Spearman correlation analysis found that Ruminococcus,Streptococcus and Butyricococcus were negatively correlated with OGTT 0 h blood glucose(P<0.05);Dialister,Blautia and Monoglobus were negatively correlated with OGTT 1 h blood glucose(P<0.05);Lachnospiraceae and Prevotella were negatively correlated with OGTT 2 h blood glucose(P<0.05).Conclusion 16S r DNA high-throughput sequencing technology is helpful for analysis of the diversity of intestinal flora in GDM pregnant women.It may provide new ideas and theoretical basis for the study of the intestinal flora of GDM pregnant women and its correlation with blood glucose.