早发2型糖尿病肠道菌群分布特征研究

Study on the distribution characteristics of gut microbiota in early-onset type 2 diabetes mellitus

目的探讨早发T2DM(EOD)肠道菌群分布特征。方法选取2019年11月至2020年11月于我院内分泌科住院的新发T2DM患者39例,其中EOD患者21例(EOD组),其余18例为T2DM组,另选取同期长期居住长沙市健康人群29名为正常对照(NC)组。收集研究对象临床指标及粪便,行16S rRNA测序,比较各组肠道菌群差异。结果与T2DM组比较,EOD组年龄、HDL-C、FC-P降低(P<0.05或P<0.01),HbA1c、糖尿病酮症比例升高(P<0.05)。与NC组比较,EOD、T2DM组α多样性Observed-species指数、β多样性升高(P<0.05或P<0.01)。线性判别效应分析显示,与T2DM组比较,EOD组肠道菌群大肠杆菌-志贺菌属、大肠杆菌、克雷伯氏菌属丰度升高(P<0.05),厚壁菌门的布劳特氏菌属丰度升高,拟杆菌门的普雷沃氏菌属、拟杆菌属丰度降低。Spearman相关分析显示,在EOD组中富集的变形菌门、大肠杆菌-志贺菌属、克雷伯氏菌属与BMI、FPG、HbA1c、TG呈正相关(P<0.01),与HDL-C呈负相关(P<0.01)。粪杆菌属、罗氏菌属与HDL-C呈正相关(P<0.01),与BMI、HbA1c、FPG、TG呈负相关(P<0.01)。结论EOD患者大肠杆菌-志贺菌属和克雷伯杆菌属在内的变形菌门丰度升高,拟杆菌属丰度降低。

Objective To investigate the distribution characteristics of gut microbiota in patients with early-onset(EOD)type 2 diabetes mellitus(T2DM).Methods A total of 39 hospitalized newly diagnosed T2DM patients were enrolled in this study from our hospital during November 2019 to November2020.All the patients were divided into two groups:early-onset type 2 diabetes mellitus(EOD group,n=21)and late-onset T2DM(T2DM group,n=18).Another 29 healthy volunteers were recruited as NC group.Clinical indexes were collected and feces were collected for 16S rRNA sequencing to determine the characteristics of gut microbiota.Results Compared with T2DM group,age,HDL-C,and FC-P were all lower(P<0.05 or P<0.01),while HbA1c,the rate of diabetic ketosis were higher in EOD group(P<0.05).Compared with NC group,theαdiversity(Observed-species index)andβdiversity were higher in EOD and T2DM group(P<0.05 or P<0.01).LEFse analysis found that compared with T2DM group,the abundance of Escherichia coli-Shigella,Escherichia coli,Klebsiella and Blautia significantly increased(P<0.05),while the abundance of Prevotella and Bacteroides decreased in EOD group.Spearman correlation analysis showed that in EOD group,Escherichia coli,Shigella and Klebsiella were positively correlated with BMI,FPG,HbA1c and TG(P<0.01),and negatively correlated with HDL-C(P<0.01).Faecalibacterium and Roseburia were negatively correlated with BMI,HbA1c,FPG and TG(P<0.01),and positively correlated with HDL-C(P<0.01).Conclusion The abundance of Proteobacteria,including Escherichia coli,Shi-gella and Klebsiella,increased,while the abundance of Bacteroidetes decreased in EOD.