多囊卵巢综合征患者肠道菌群失调及其与胰岛素抵抗的相关性研究

Intestinal flora imbalance in patients with polycystic ovary syndrome and its relationship with insulin resistance

目的探讨多囊卵巢综合征患者肠道菌群失调及其与胰岛素抵抗的相关性。方法选取2020年6月至2022年6月十堰市人民医院收治的50例(25.98±0.95)岁的多囊卵巢综合征患者作为研究组。另选取同期月经规律的50名(26.02±1.01)岁的健康女性作为健康对照组。对所有研究对象胰岛素抵抗进行检测,并分析研究对象的肠道菌群分布特点。对比两组肠道菌群分布特点、胰岛素指标,分析多囊卵巢综合征患者肠道菌群失调及其与胰岛素抵抗的相关性。采用t检验、χ^(2)检验进行统计学分析。结果两组研究对象肠道菌群经过聚类分析后得到了操作分类单元(OTU)代表序列372个,其中研究组特有OTU序列60个,健康对照组特有OTU序列90个,两组共有OTU序列111个;Alpha分析结果显示,研究组OTU序列数量、Shannon指数低于健康对照组(均P<0.05)。研究组门水平上厚壁菌门相对丰度高于健康对照组,拟杆菌门相对丰度低于健康对照组(均P<0.05);研究组属水平上布劳特菌属、拟杆菌属、粪便杆菌属相对丰度均低于健康对照组,霍氏真杆菌相对丰度高于健康对照组(均P<0.05)。研究组空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均高于健康对照组[(9.55±1.98)mIU/L比(6.71±1.92)mIU/L、(2.08±0.50)比(1.49±0.40),均P<0.05]。拟杆菌属与HOMA-IR呈正相关(r=0.281,P<0.05),粪便杆菌属与HOMA-IR呈负相关(r=-0.331,P<0.05)。结论多囊卵巢综合征患者存在菌群失调的现象,且肠道菌群失调的发生与胰岛素抵抗密切相关。检测患者肠道菌群水平可以为临床多囊卵巢综合征患者的诊断、治疗提供参考与依据。

Objective To investigate the intestinal flora imbalance in patients with polycystic ovary syndrome(PCOS)and its relationship with insulin resistance.Methods Fifty(25.98±0.95)years old patients with PCOS treated at Shiyan People's Hospital from June 2020 to June 2022 were selected as a study group.Fifty(26.02±1.01)years old healthy women with regular menstruation during the same period were selected as a healthy control group.All the subjects were tested for insulin resistance.The characteristics of intestinal flora distribution were analyzed.The intestinal flora distribution characteristics and insulin indicators of the two groups were compared to analyze the intestinal flora imbalance and its correlation with insulin resistance in the patients with PCOS.t test andχ^(2) test were used for the statistical analysis.Results After the cluster analysis,372 operational taxonomic unit(OTU)representative sequences were obtained,including 60 OTU sequences specific to the study group and 90 OTU sequences specific to the healthy control group;there were 111 shared OTU sequences in the two groups;the results of Alpha analysis showed that the number of OTU and Shannon index in the study group were lower than those in the healthy control group(both P<0.05).The relative abundance of Firmicutes at the phylum level in the study group was higher than that in the healthy control group,and the relative abundance of Bacteroidetes in the study group was lower than that in the healthy control group(both P<0.05);the relative abundances of Brucella,Bacteroidetes,and Faecobacter at the genus level were lower than those in the healthy control group,and the relative abundance of Eubacterium Hoveri in the study group was higher than that in the control group(all P<0.05).The fasting insulin(FINS)and insulin resistance index(HOMA-IR)in the study group were higher than those in the healthy control group[(9.55±1.98)mIU/L vs.(6.71±1.92)mIU/L and(2.08±0.50)vs.(1.49±0.40);both P<0.05].Bacteroides was positively correlated with HOMA-IR(r=0.281,P<0.05),and fecal bacillus negatively with HOMA-IR(r=-0.331,P<0.05).Conclusion Patients with PCOS have microflora dysregulation,and the occurrence of intestinal microflora dysregulation is closely related to insulin resistance.The detection of their intestinal microflora level can provide references and basis for the clinical diagnosis and treatment of patients with PCOS.