新诊断2型糖尿病合并高尿酸血症患者的临床特征及肠道菌群变化
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E-mail:drliuyu@njmu.edu.cn

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R587.1

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国家自然科学基金(81770778)


The study of clinical features and gut microbiome of newly diagnosed type 2 diabetes patients with hyperuricemia
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    摘要:

    目的:通过对2 型糖尿病(type 2 diabetes mellitus,T2DM)合并高尿酸血症(hyperuricemia,HUA)患者的临床特征及肠道菌群组成分析,旨在为该疾病的预防及微生态治疗提供新依据。方法:纳入103例单纯新诊断T2DM患者,98例T2DM合并HUA患者。按照入排条件,选取年龄及性别匹配的新诊断T2DM合并HUA患者(DMUA组)及单纯新诊断T2DM患者(T2DM 组),同期纳入年龄及性别匹配的HUA患者(HUA组)及健康志愿者(Control组)。收集所有研究对象的临床资料及生化检测结果,通过卡方检验、方差分析、Tukey⁃HSD检验及Wilcoxon秩和检验法进行分析。并分别采集4组研究对象的粪便标本,用16S rRNA高通量测序方法检测4组研究对象的肠道菌群,并用生物信息学进行分析。结果:①临床特征比较:DMUA组患者的低密度脂蛋白水平较T2DM病程>5年组显著升高,同时总胆固醇、甘油三酯、胰岛素、C肽水平、动脉硬化指数及脂肪肝发生率较单纯新诊断T2DM组显著升高。此外,与T2DM组相比其发病年龄更早,但其糖化血红蛋白显著降低。与T2DM组、HUA组及 Control组相比,DMUA组高密度脂蛋白显著降低而甘油三酯明显升高;与T2DM组、HUA组相比,DMUA组动脉硬化指数显著升高。②肠道菌群分析:DMUA组α多样性指数比Control组显著降低。DMUA组与Control 组及HUA组相比β多样性存在明显差异。在菌群丰度分析中,DMUA组与HUA组相比,f_Prevotellaceae和g_Megamonas显著增加,而p_Bacteroidetes、c_Bacteroid⁃ ia、o_Bacteroidales、f_Bacteroidaceae、g_Bacteroides、f_tannerellaceae 和g_Parabacteroides 明显减少。DMUA组与Control组相比, c_Clostridia、o_Clostridiales、f_Peptostreptococcaceae、g_Romboutsia 显著减少。结论:新诊断 T2DM 合并 HUA 组与长病程的 T2DM合并HUA组及单纯新诊断T2DM组相比,更易出现脂代谢异常。DMUA组的肠道菌群结构与T2DM组、HUA组及Control 组存在差异,可能与新诊断T2DM合并HUA患者疾病的发生发展存在一定的联系。

    Abstract:

    Objective:The study aims to provide new targets for the prevention and treatment of newly diagnosed T2DM with HUA by analyzing the clinical features and the gut microbiome.Methods:A total of 103 patients with newly diagnosed T2DM and 98 patients with T2DM with HUA were included. According to the admission conditions,agE- and gender⁃matched newly diagnosed T2DM patients with HUA(DMUA group) and newly diagnosed T2DM patients(T2DM group) were selected,and age ⁃ and gender ⁃ matched hyperuricemia patients(HUA group)and healthy volunteers(Control group)were included at the same time. The clinical data and biochemical test results were recorded. The data were analyzed by chi⁃square test,analysis of variance,Tukey⁃HSD Test and Wilcoxon rank sum test method. Stool samples of 4 groups were collected and sequenced by 16S rRNA high⁃throughput sequencing method and all the data were finally analyzed by bioinformatics. Results:①Comparison of clinical features:CHO,TG,AI were higher in DMUA than T2DM group,LDL in DMUA was only higher than the T2DM group with a history of more than 5 years. DMUA group were youngerand had a greater prevalence of fatty liver than T2DM group,but HbA1c in DMUA was lower than T2DM group. Compared with the T2DM group,HUA group and the Control group,the DMUA group had a significant decrease in high ⁃ density lipoprotein and a significant increase in triglycerides. And compared with the T2DM group and HUA group,the arteriosclerosis index of DMUA groups was significantly increased.②The gut microbiome analysis:The α diversity index of the DMUA group was significantly lower than that of the Control group. There was a significant difference in β diversity between the DMUA group,Control group and the HUA group. In the analysis of bacteria abundance,compared with the HUA group,f_Prevotellaceae and g_Megamonas were significantly increased in the DMUA group,while p_Bacteroidetes,c_Bacteroidia,o_Bacteroidales,f_Bacteroidaceae,g_Bacteroides,f_Tannerellaceae and g_Parabacteroides were significantly decreased. Compared with the Control group, c_clostridia, o_clostridiales, f_Peptostreptococcaceae and g_Romboutsia were significantly decreased in the DMUA group. Conclusion:Compared with long⁃course T2DM with HUA and newly diagnosed T2DM alone,the group with newly diagnosed T2DM with HUA is more likely to have abnormal lipid metabolism. The gut microbiome of the DMUA group is different from that of the T2DM group,HUA group or Control group,which may be related to the occurrence and development of T2DM and HUA.

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陈柔柔,李娜,赫荣波,邹婧,刘青,张颖,刘煜.新诊断2型糖尿病合并高尿酸血症患者的临床特征及肠道菌群变化[J].南京医科大学学报(自然科学版),2022,42(8):1125-1132

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  • 在线发布日期: 2022-08-07
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