摘要
目的 探究2型糖尿病(T2DM)及糖尿病肾病(DN)患者肠道菌群失衡模式及其与炎症相关指标之间的相关性.方法 前瞻性选取2021年2月至2024年1月期间山东第一医科大学附属省立医院40例T2DM、40例DN患者及40名健康体检者作为研究对象,分别作为T2DM组、DN组及健康对照组.取受检者新鲜粪便5 g,检测肠道菌群(葡萄球菌属、乳杆菌属、假丝酵母属、肠球菌属、变形杆菌属、拟杆菌属、梭菌属、双歧杆菌属),且检测受检者血清炎症因子[白细胞介素(IL)-6、IL-8、IL-10、肿瘤坏死因子-α(TNF-α)]水平,对比3组受检者肠道菌群表达及炎症因子水平;采用Pearson相关性分析法分析二者的相关性.结果 T2DM组、DN组的葡萄球菌属、假丝酵母属、变形杆菌属、拟杆菌属、梭菌属相对度高于健康对照组,乳杆菌属、肠球菌属、双歧杆菌属相对度低于健康对照组,差异均有统计学意义(P＜0.05);DN组患者的葡萄球菌属、假丝酵母属、肠球菌属、变形杆菌属、拟杆菌属、梭菌属和双歧杆菌属相对度均高于T2DM组,乳杆菌属相对度低于T2DM组,差异均有统计学意义(P＜0.05).T2DM组、DN组患者的血清IL-6、IL-8、TNF-α水平均高于健康对照组,IL-10水平低于健康对照组,差异均有统计学意义(P＜0.05);DN组患者血清IL-6、IL-8、TNF-α水平均高于T2DM组,IL-10水平低于T2DM组,差异均有统计学意义(P＜0.05).葡萄球菌属相对度与血清IL-6、IL-8水平均呈显著正相关(r=0.754、0.818,P＜0.05);乳杆菌属相对度与血清IL-6、IL-8水平均呈负相关(r=-0.856、-0.652,P＜0.05),与IL-10水平呈正相关(r=0.745,P＜0.05);假丝酵母属相对度与血清IL-6、IL-8和TNF-α水平均呈正相关(r=0.856、0.654、0.754,P＜0.05);肠球菌属相对度与血清TNF-α水平呈负相关(r=-0.854,P＜0.05),与IL-10水平呈正相关(r=0.687,P＜0.05);拟杆菌属相对度与血清TNF-α水平呈正相关(r=0.754,P＜0.05);梭菌属与IL-10水平呈负相关(r=-0.703,P＜0.05);双歧杆菌属相对度与血清IL-6、IL-8和TNF-α水平均呈显著负相关(r=-0.754、-0.654、-0.815,P＜0.05),与IL-10水平呈正相关(r=0.742,P＜0.05).结论 T2DM和DN患者在肠道菌群失衡模式和炎症因子表达之间存在明显相关性,上述结果为进一步研究这些疾病的病理生理机制和潜在治疗靶点提供重要线索.
Abstract
Objective To explore the gut microbiota imbalance patterns in patients with type 2 diabetes mellitus(T2DM)and diabetic nephropathy(DN)and their correlation with inflammatory markers.Methods Forty patients with T2DM,40 patients with DN and 40 healthy people in the Shandong First Medical University Affiliated Provincial Hospital from February 2021 to January 2024 were prospectively selected as the research objects,and they were divided into the T2DM group,the DN group and the healthy control group.Stool samples(5 g)were collected from the subjects to detect gut microbiota(Staphylococcus,Lactobacillus,Candida,Enterococcus,Proteus,Bacteroides,Clostridium,Bifidobac-terium),and the levels of inflammatory markers[interleukin(IL)-6,IL-8,IL-10,tumor necrosis factor-alpha(TNF-α)]in the partici-pants'serum were assessed.The differences in gut microbiota expression and inflammatory markers among the three groups were compared,and Pearson correlation analysis was employed to analyze their correlation.Results The relative ratios of Staphylococcus,Candida,Proteus,Bacte-roides and Clostridium in the T2DM and DN groups were higher than those in the healthy control group,while the relative ratios of Lactobacillus,Enterococcus and Bifidobacterium were lower than those in the healthy control group,the differences were statistically significant(P＜0.05).The relative degrees of Staphylococcus,Candida,Enterococcus,Proteus,Bacteroides,Clostridium and bifidobacteria in the DN group were higher than those in the T2DM group,while the relative degrees of Lactobacillus were lower than those in the T2DM group,the differences were statisti-cally significant(P＜0.05).The levels of serum IL-6,IL-8 and TNF-α in the T2DM and DN groups were higher than those in the healthy control group,and IL-10 was lower than those in healthy control group,the differences were statistically significant(P＜0.05).The levels of serum IL-6,IL-8 and TNF-α in the DN group were higher than those in the T2DM group,and IL-10 was lower than those in the T2DM group,the differences were statistically significant(P＜0.05).Staphylococcus relative degree was positively correlated with serum IL-6 and IL-8 levels(r=0.754,0.818;P＜0.05).The relative degree of Lactobacillus was negatively correlated with serum IL-6 and IL-8 levels(r=-0.856,-0.652;P＜0.05),and positively correlated with IL-10 level(r=0.745,P＜0.05).The relative degree of Candida genus was positively correlated with serum IL-6,IL-8 and TNF-α levels(r=0.856,0.654,0.754;P＜0.05).The relative degree of Enterococ-cus was negatively correlated with serum TNF-α level(r=-0.854,P＜0.05)and positively correlated with IL-10 level(r=0.687,P＜0.05).The relative degree of Bacteroides was positively correlated with serum TNF-α level(r=0.754,P＜0.05).Clostridium was negatively correlated with IL-10 level(r=-0.703,P＜0.05).The relative degree of bifidobacterium was negatively correlated with serum IL-6,IL-8 and TNF-α levels(r=-0.754,-0.654,-0.815;P＜0.05),and positively correlated with IL-10 level(r=0.742,P＜0.05).Conclusion There is a significant correlation between the imbalance pattern of intestinal flora and the expression of inflammatory factors in pa-tients with T2DM and DN.The above results provide important clues for further study on the pathophysiological mechanisms and potential therapeu-tic targets of these diseases.
维普
万方数据