Page 83 - 南京医科大学学报自然科学版

第42卷第8期 南京医科大学学报（自然科学版）
2022年8月 Journal of Nanjing Medical University（Natural Sciences） ·1125 ·

·临床研究·

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

陈柔柔，李 娜，赫荣波，邹 婧，刘 青，张 颖，刘 煜 *
南京医科大学附属逸夫医院内分泌科，江苏 南京 211100

［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。
［关键词］ 2型糖尿病；高尿酸血症；肠道菌群；16S rRNA
［中图分类号］ R587.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）08⁃1125⁃09
doi：10.7655/NYDXBNS20220812

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

*
CHEN Rourou，LI Na，HE Rongbo，ZOU Jing，LIU Qing，ZHANG Ying，LIU Yu
Department of Endocrinology and Metabolism，Sir Run Run Hospital，Nanjing Medical Universtiy，Nanjing 211100，
China

［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 younger
［基金项目］ 国家自然科学基金（81770778）
∗
通信作者（Corresponding author），E⁃mail：drliuyu@njmu.edu.cn