多囊卵巢综合征患者肠道菌群微生态与脂质代谢的关系

Relationship between intestinal flora microecology and lipid metabolism in patients with polycystic ovary syndrome

目的 分析多囊卵巢综合征(PCOS)患者肠道菌群微生态与脂质代谢的关系。方法 在2020年1月至2021年6月期间纳入绝经前妇女,包括47例PCOS患者(PCOS组)及41例健康妇女(对照组)。应用酶试剂盒测量血清脂质谱。采用16SrRNA基因扩增子测序及数据处理分析粪便样本的肠道菌群。结果 PCOS组患者的低密度脂蛋白胆固醇、总胆固醇、载脂蛋白B水平更高,而高密度脂蛋白胆固醇更低(P<0.05)。PCOS组患者的OTU总数更低[(137.15±33.47)个vs.(159.32±36.31)个,t=2.979,P=0.004]及Shannon指数均低于对照组(5.46±0.50vs.5.69±0.49,t=2.173,P=0.033)。25种肠道菌群在PCOS组及对照组间差异有统计学意义(P<0.05)。经Spearman相关性分析,阿克曼氏菌科、颤螺旋菌科、norank-Clostridia-UCG-014、克里斯滕森菌科和UCG-010与脂类代谢指标相关性最显著(P<0.05)。结论 PCOS存在脂质代谢异常情况,并且其肠道菌群也发生失调。肠道菌群的失调可能会加剧PCOS患者脂质代谢紊乱。

Objective To analyze the relationship between intestinal flora microecology and lipid metabolism in patients with polycystic ovary syndrome(PCOS).Methods Premenopausal women were enrolled between January 2020 and June 2021,including 47 PCOS patients(PCOS group)and 41 healthy women(control group).Serum lipid profiles were measured using an enzyme kit.The intestinal flora of fecal samples were analyzed by 16S rRNA gene amplicon sequencing and data processing.Results The levels of low density lipoprotein cholesterol,total cholesterol and apolipoprotein B were higher in PCOS group,while the level of high density lipoprotein cholesterol were lower(P<0.05).The total number of OTU in PCOS group was lower than that in control group(137.15±33.47 vs.159.32±36.31,t=2.979,P=0.004)and Shannon index was lower than that in control group(5.46±0.50 vs.5.69±0.49,t=2.173,P=0.033).There were significant differences in 25 kinds of intestinal flora between PCOS group and control group(P<0.05).By Spearman correlation analysis,Akkermansiaceae,Oscillospiraceae,norank-Clostridia-UCG-014,Christensenellaceae and UCG-010 were most significantly correlated with lipid metabolism indexes(P<0.05).Conclusion PCOS has abnormal lipid metabolism and abnormal intestinal flora.Imbalance of intestinal flora may exacerbate lipid metabolism disorders in PCOS patients.