非酒精性脂肪性肝病合并T2DM患者肠道菌群结构变化研究*

doi:10.3969/j.issn.1672-5069.2022.01.014

摘要/Abstract

摘要： 目的探讨非酒精性脂肪性肝病(NAFLD)合并2型糖尿病(T2DM)患者肠道菌群结构的变化。方法 2018年6月～2020年7月我院诊治的NAFLD合并T2DM患者58例、NAFLD患者66例和健康人60例,采用二代基因测序技术,针对16 srRNA基因V3～V4高变序列进行扩增测序,通过与肠道菌群GENBA-NK数据库进行序列比对,分析肠道菌群的种类和结构。采用化学发光法测定血清空腹胰岛素(FINS),并计算稳态模型胰岛素抵抗(HOMA-IR)指数;采用ELISA法测定血清肿瘤坏死因子-α(TNF-α),采用免疫层析法测定血清超敏C反应蛋白(hs-CRP)。结果 NAFLD合并T2DM组粪拟杆菌门显著高于NAFLD组或健康人(P＜0.05),NAFLD组粪拟杆菌门又显著高于健康人(P＜0.05);NAFLD合并T2DM组粪厚壁菌门、柔嫩梭菌属、厌氧棍状菌属和布劳特菌属丰度均显著低于NAFLD组或健康人(P＜0.05),NAFLD组厚壁菌门、柔嫩梭菌属、厌氧棍状菌属和布劳特菌属丰度又均显著低于健康人(P＜0.05);NAFLD合并T2DM组HOMA-IR指数、血清TNF-α和hs-CRP水平分别为(2.8±1.3)、(52.3±11.7)ng/mL和(2.3±1.1)mg/L,显著高于NAFLD组【分别为(1.6±0.7)、(48.7±10.2)ng/mL和(1.6±0.9)mg/L,P<0.05】或健康人【分别为(1.3±0.3)、(33.2±8.4)ng/mL和(1.2±0.4)mg/L,P<0.05】。结论 NAFLD合并T2DM患者存在胰岛素抵抗和血清炎性因子水平的变化,而且肠道菌群结构也发生了显著的改变,需进一步研究其临床意义。

关键词: 非酒精性脂肪性肝病, 2型糖尿病, 肠道菌群, 胰岛素抵抗, 细胞因子

Abstract: Objective The aim of this study was to investigate the structure of intestinal flora changes in patients with non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus type 2(T2DM). Methods 58 patients with NAFLD and T2DM, 66 patients with NAFLD and 60 healthy volunteers were encountered in our hospital between June 2018 and July 2020. The intestinal flora structure, the homeostasis model assessment-insulin resistance steady state model insulin resistance (HOMA-IR) and serum tumor necrosis factor-α(TNF-α) and high-sensitivity C-reactive protein levels were detected. Results The fecal phylum of Bacteroides in patients with NAFLD and T2DM was significantly higher than that in patients with NAFLD or in healthy control (P＜0.05), and the phylum of Bacteroides in patients with NAFLD was significantly higher than that in healthy control (P＜0.05); the abundances of fecal Firmicutes, Clostridium tenuis, Anaerobic Streptomyces and Blautella in patients with NAFLD and T2DM were significantly lower than those in patients with NAFLD or in healthy individuals (P＜0.05), and the abundances of Firmicutes, Clostridium tenuis, Anaerobic bacillus, and Blautella in patients with NAFLD were all significantly lower than those in the healthy control (P<0.05); the HOMA-IR index, serum TNF-α and hs-CRP levels in patients with NAFLD and T2DM were (2.8±1.3), (52.3±11.7)ng/mL and (2.3±1.1)mg/L, significantly higher than [(1.6±0.7), (48.7±10.2)ng/mL and (1.6±0.9)mg/L, respectively, P<0.05] in patients with NAFLD or [(1.3±0.3), (33.2±8.4)ng/mL and (1.2±0.4)mg/L, respectively, P<0.05] in healthy individuals. Conclusion The patients with NAFLD and T2DM have insulin resistance and serum inflammatory factor disorders, as well as the structure changes of intestinal flora, which needs further investigation for its clinical implications.

Key words: Non-alcoholic fatty liver disease, Type 2 diabetes mellitus, Intestinal flora, Insulin resistance, Inflammatory factors

任洁, 郝巧歆, 黄成河, 陈勋, 卢欣. 非酒精性脂肪性肝病合并T2DM患者肠道菌群结构变化研究^*[J]. 实用肝脏病杂志, 2022, 25(1): 54-57.

Ren Jie, Hao Qiaoyun, Huang Chenghe, et al. Structure of intestinal flora changes in patients with non-alcoholic fatty liver disease and diabetes mellitus type 2[J]. Journal of Practical Hepatology, 2022, 25(1): 54-57.

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非酒精性脂肪性肝病合并T2DM患者肠道菌群结构变化研究^*

Structure of intestinal flora changes in patients with non-alcoholic fatty liver disease and diabetes mellitus type 2

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