肌少症患者肠道菌群变化与血清炎症因子相关性分析

Correlation analysis of intestinal flora changes and serum inflammatory factors in patients with sarcopenia

[目的]探讨老年肌少症患者肠道菌群、炎症因子的变化及特点,以及两者之间的相关性,为老年人肌少症的早期识别、尽早干预及治疗提供参考。[方法]纳入206例老年患者为研究对象,分为正常组(n=98)、肌少症组(n=108)。收集所有患者的一般资料,以及白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数、中性粒细胞百分比、白蛋白等实验室检查结果;粪便标本采用16 S rRNA测序分析肠道菌群,分析肠道菌群组成与炎症因子的相关性。[结果]肌少症组患者总体文化程度、握力、白蛋白水平、体质指数低于正常组,而CRP、IL-6高于正常组患者,差异均有统计学意义(P<0.05)。肌少症组与正常组相比在肠道菌群的组成比较差异有统计学意义(P<0.05),2组间大肠杆菌丰度与患者的骨骼肌质量指数呈负相关,与IL-6水平呈正相关;乳酸杆菌、罗氏菌属及直肠真杆菌、毛螺菌属丰度与骨骼肌质量呈正相关,乳酸杆菌、罗氏菌属丰度与IL-6呈负相关;乳酸杆菌、毛螺菌属及直肠真杆菌丰度与握力呈正相关,均差异有统计学意义(P<0.05)。[结论]老年肌少症患者存在肠道菌群紊乱,致病菌群丰度增加,且此类菌群丰度与骨骼肌质量指数呈负相关,与IL-6水平呈正相关;抗炎菌群丰度减少,且此类菌群丰度与骨骼肌质量指数及握力呈正相关,与IL-6水平呈显著负相关。

[Objective]To explore the changes and characteristics of gut microbiota and inflammatory factors in elderly patients with sarcopenia,as well as the correlation between the two,in order to provide reference for early identification,intervention,and treatment of sarcopenia in the elderly.[Methods]The totals of 206 elderly patients were divided into a normal group(n=98)and a sarcopenia group(n=108).Collect general information of all patients,as well as laboratory test results such as IL-6,CRP,PCT,white blood cell count,neutrophil percentage,albumin,etc.Fecal samples were analyzed for gut microbiota using 16 S rRNA sequencing,and the correlation between gut microbiota composition and inflammatory factors was analyzed.[Results]A total of 98 normal patients and 108 patients with sarcopenia were included in this study.The overall education level,grip strength,albumin level,and body mass index of the sarcopenia group were lower than those of the normal group,while CRP and IL-6 were higher than those of the normal group,with statistical significance(P<0.05).The composition of intestinal flora in myopenia group was significantly different from that in normal group(P<0.05).The abundance of Lactobacillus,Rochella,Eubacterium rectum and Spirillum was positively correlated with the quality of skeletal muscle,while the abundance of Lactobacillus and Rochella was negatively correlated with IL-6.The abundance of lactobacillus,Spirillum and rectal eubacteria were positively correlated with grip strength,and the difference was statistically significant(P<0.05).[Conclusion]Elderly patients with sarcopenia have intestinal microbiota disorder,with an increase in the abundance of pathogenic microbiota.The abundance of such microbiota is negatively correlated with skeletal muscle mass index(SMMI)and positively correlated with IL-6 levels.The abundance of anti-inflammatory microbiota decreased,and the abundance of such microbiota was positively correlated with SMMI and grip strength,while significantly negatively correlated with IL-6 levels.