非酒精性肝病患者血糖和肝功能指标与肠道菌群多样性的相关性

Correlations of blood glucose and liver function indicators with gut microbiota diversity in patients with non-alcoholic liver disease

目的观察非酒精性肝病患者肠道菌群特征,分析其与血糖和肝功能代谢指标水平的相关性。方法选取2023年3月至2023年10月于湖州市第一人民医院门诊招募的受试者83人,其中非酒精性肝病患者33人(肝病组)、健康体检者50人(对照组)。对其粪便样本进行16S rRNA基因测序,通过Illumina测序平台对肠道菌群alpha多样性和beta多样性进行生物信息学分析,采用Spearman秩相关分析血糖和肝功能指标水平与肠道菌群多样性的关系。结果与对照组比较,肝病组患者的alpha多样性指数显著降低(t=2.693,P=0.027),同时丰度降低的厚壁菌门与HbA1c呈显著负相关(r=-0.389,P=0.025),丰度升高的拟杆菌门与HbA1c呈显著正相关(r=0.389,P=0.025)。肝病组患者中丰度降低的栖粪杆菌属和罗氏菌属均与HbA1c呈显著负相关(r=-0.494、-0.359,P=0.003、0.040),而丰度降低的普氏菌属与HbA1c和ALT呈显著正相关(r=0.448,P=0.009;r=0.410,P=0.018),丰度升高的拟杆菌属与HbA1c和ALT呈显著负相关(r=-0.351,P=0.045;r=-0.393,P=0.024)。结论非酒精性肝病患者的肠道菌群结构发生显著变化,且肠道菌群丰度的变化伴随着HbA1c和ALT水平不同程度的改变,这些菌群可能有助于非酒精性肝病的诊断、预防和治疗。

Objective To observe the characteristics of gut microbiota in patients with non-alcoholic liver disease(NALD)and analyze its correlations with blood glucose and liver metabolic indicators.Methods A total of 83 subjects were recruited from the outpatient department of our hospital from March 2023 to October 2023,including 33 patients with NALD(liver disease group)and 50 healthy individuals(control group).Fecal samples were collected;16S rRNA gene sequencing and alpha diversity and beta diversity analyses were performed by using Illumina platform.Spearman rank correlation was used to analyze the relationship of blood glucose and liver function index levels with gut microbiota diversity.Results Compared with the control group,the alpha diversity of intestinal flora in liver disease group significantly decreased(t=2.693,P=0.027);the Firmicutes with decreased abundance showed a significant negative correlation with HbA1c(r=−0.389,P=0.025),while the Bacteroidetes with increased abundance showed a significant positive correlation with HbA1c(r=0.389,P=0.025).In liver disease group,Faecalibacterium and Roseburia with decreased abundance were significantly negatively correlated with HbA1c(r=−0.494,−0.359;P=0.003,0.040),while Prevolla with decreased abundance was significantly positively correlated with HbA1c and ALT(r=0.448,P=0.009;r=0.410,P=0.018),and the Bacteroides with increased abundance was significantly negatively correlated with HbA1c and ALT(r=−0.351,P=0.045;r=−0.393,P=0.024).Conclusion The structure of gut microbiota in patients with NALD has significantly changed,and changes in gut microbiota abundance are accompanied by varying degrees of changes in HbA1c and ALT indicators.These bacteria may contribute to the diagnosis,prevention,and treatment of NALD.