| 杨道杰,饶立科,丁国美.糖尿病肾病患者肠道菌群特征及与肾功能等相关性研究[J].浙江中西医结合杂志,2024,34(12): |
| 糖尿病肾病患者肠道菌群特征及与肾功能等相关性研究 |
| Study on the Characteristics of Intestinal Microflora in Patients with diabetes Nephropathy and Its Correlation with Renal Function |
| 投稿时间：2024-03-25 修订日期：2024-11-05 |
| DOI： |
| 中文关键词: 糖尿病肾病 肠道菌群 肾功能 |
| 英文关键词:diabetes nephropathy intestinal microbiota renal function |
| 基金项目:浙江省中医药科技计划项目（2024ZL762）， 杭州市医药卫生科技项目（A20220865）。 |
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| 中文摘要: |
| 目的：探究糖尿病肾病（diabetic kidney disease,DKD）患者与普通人群肠道菌群特征差异，及与肾功能等相关性研究。方法：选取杭州市红十字会医院钱塘院区2022年1月-2022年12月门诊就诊的DKD患者50例，招募普通人群50例作为研究对象，采取所有人粪便后以16S rRNA基因测序方法进行肠道菌群丰度及多样性检测，留取血液、尿液样本，检测、计算尿微量白蛋白/尿肌酐（albumin creatine ratio ,ACR）、24小时尿蛋白定量（24-hour urine protein quantification,24hPro）、血肌酐（creatinine,Cr）、血尿素氮（blood urea nitrogen,Bun）、肾小球滤过率（glomerular filtration rate,GFR）、空腹血糖（fasting blood glucose,FBG）、糖化血红蛋白（hemoglobin A1c,HbA1c）等指标，分析两组人群肠道菌群种属、丰度、多样性差异，及DKD患者肠道菌群与上述指标的相关性。结果：（1）DKD组与普通对照组的肠道菌群在门层次上丰度占比前三均为拟杆菌、厚壁菌和变形杆菌，但DKD组较普通对照组的拟杆菌、厚壁菌占比低，变形杆菌占比高。（2）在肠道菌群多样性方面，两组的Chao1与ACE指数对比无显著性差异，而DKD组的Shannon与Simpson指数较普通人群组高。（3）DKD组肠道菌群中拟杆菌、厚壁菌水平与ACR、24hPro、Cr、Bun呈负相关，与GFR呈正相关；变形杆菌水平与ACR、24hPro、Cr、Bun呈正相关，与GFR呈负相关。结论：DKD患者肠道菌群以拟杆菌、厚壁菌、变形杆菌为主，且拟杆菌、厚壁菌占比较普通人群更低，变形杆菌占比更高，同时两组菌群的丰富度差异不大，但DKD组的菌群多样性较高。此外，DKD患者拟杆菌、厚壁菌水平与ACR、24hPro、Cr、Bun呈负相关，与GFR呈正相关；变形杆菌水平与ACR、24hPro、Cr、Bun呈正相关，与GFR呈负相关。 |
| 英文摘要: |
| Objective: Objective: To explore the difference of intestinal flora characteristics between diabetic kidney disease (DKD) patients and the general population, and to study the correlation with renal function. Method: Fifty DKD patients who visited the Qiantang campus of Hangzhou Red Cross Hospital from January 2022 to December 2022 were selected as the study subjects, and 50 ordinary people were recruited as the research subjects. The abundance and diversity of gut microbiota were detected using 16S rRNA gene sequencing method after feces were collected from all individuals. Blood and urine samples were collected to detect and calculate urine albumin creatine ratio (ACR), 24-hour urine protein quantification (24h Pro), blood creatinine (Cr), blood urea nitrogen (Bun), glomerular filtration rate (GFR), fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and other indicators. The two groups of people were analyzed. Differences in the species, abundance, and diversity of gut microbiota, as well as the correlation between gut microbiota and the above indicators in DKD patients. Result: (1) The abundance of gut microbiota in the DKD group and the normal control group at the phylum level was mainly composed of Bacteroidetes, Firmicutes, and Proteus. However, the DKD group had a lower proportion of Bacteroidetes and Firmicutes compared to the normal control group, while the proportion of Proteus was higher. (2) In terms of gut microbiota diversity, there was no significant difference in the Chao1 and ACE indices between the two groups, while the Shannon and Simpson indices of the DKD group were higher than those of the general population group. (3) The levels of Bacteroidetes and Firmicutes in the gut microbiota of DKD group were negatively correlated with ACR, 24h Pro, Cr, Bun, and positively correlated with GFR; The level of Proteus is positively correlated with ACR, 24h Pro, Cr, Bun, and negatively correlated with GFR. Conclusion: The gut microbiota of DKD patients is mainly composed of Bacteroidetes, Firmicutes, and Proteus, with a lower proportion of Bacteroidetes and Firmicutes compared to the general population, and a higher proportion of Proteus. At the same time, there is not much difference in the richness of the two groups of microbiota, but the diversity of the DKD group's microbiota is higher. In addition, the levels of Bacteroides and Firmicutes in DKD patients were negatively correlated with ACR, 24h Pro, Cr, Bun, and positively correlated with GFR; The level of Proteus is positively correlated with ACR, 24h Pro, Cr, Bun, and negatively correlated with GFR. |
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