摘要
目的比较糖尿病合并或不合并高血压患者之间肠道菌群的差异,为相关机制探讨提供科学依据。方法选取2018年中国健康与营养调查中糖尿病患者作为研究对象,根据是否合并高血压将其分为单纯糖尿病组和糖尿病合并高血压组。利用Illumina HiSeq PE-250对患者的粪便样本进行16S rRNA测序,结合患者主观自报和客观检测数据判定糖尿病和高血压。采用Wilcoxon检验和置换多元方差分析比较两组患者肠道菌群的α多样性和β多样性,采用多因素logistic回归模型探索肠道菌群及菌群保护得分(microbiota protection score,MPS)与糖尿病合并高血压风险的关联,MPS得分基于回归模型中与疾病风险负相关的肠道菌属数量加和构建。结果纳入1444例糖尿病患者,单纯糖尿病组和糖尿病合并高血压组的核心肠道菌属分布类似,但后者肠道中乳酸杆菌属的丰度更高,α多样性更低,两组间肠道菌群组成差异有统计学意义(R2=0.002,P=0.008)。调整相关协变量后,有7个厚壁菌门梭菌纲的菌属与糖尿病患者合并高血压风险呈负向关联。MPS得分每增加1分,糖尿病患者合并高血压风险降低14%(OR=0.86,95%CI:0.80~0.92)。与MPS得分<2分者(Q1)相比,MPS得分在3~<5分(Q3)和≥5分(Q4)时,糖尿病患者合并高血压的风险可分别降低35%(OR=0.65,95%CI:0.43~0.97)和57%(OR=0.43,95%CI:0.29~0.63)。结论糖尿病患者合并或不合并高血压之间肠道菌群存在差异,厚壁菌门梭菌纲的相关肠道菌属与糖尿病患者合并高血压风险存在负向关联。
Objective To compare the differences in gut microbiota between diabetic patients with or without hypertension,and to provide a scientific basis for exploring related mechanisms.Methods Participants were selected from the 2018 China Health and Nutrition Survey,focusing on individuals diagnosed with diabetes.They were divided into two groups:those with diabetes alone and those with diabetes combined with hypertension.Fecal samples were sequenced using 16S rRNA sequencing via Illumina HiSeq PE-250.Diabetes and hypertension diagnoses were determined through both subjective selfreports and objective measurements.The Wilcoxon test and permutation multivariate analysis of variance(PERMANOVA)were used to compare theαandβdiversity of the gut microbiota between the two groups.Multivariate logistic regression models were employed to explore the association between gut microbiota and the risk of hypertension in diabetes patients,with the microbiota protection score(MPS)calculated based on the sum of gut genera negatively correlated with disease risk.Results A total of 1444 diabetic patients were included in the study.The core gut microbiota distributions were similar between the diabetes alone group and the diabetes with hypertension group;however,the latter exhibited a higher abundance of Lactobacillus and lowerαdiversity.Statistically significant differences in gut microbiota composition were observed between the two groups(R2=0.002,P=0.008).After adjusting for relevant covariates,seven genera from the Clostridiales class of the Firmicutes phylum were negatively associated with the risk of hypertension in patients with diabetes.For each 1-point increase in MPS,the risk of diabetes combined with hypertension decreased by 14%(OR=0.86,95%CI:0.80-0.92).Compared to those with an MPS score of less than 2(Q1),patients with scores of 3 to<5(Q3)and≥5(Q4)had their risk of hypertension reduced by 35%(OR=0.65,95%CI:0.43-0.97)and 57%(OR=0.43,95%CI:0.29-0.63),respectively.Conclusions There are significant differ ences in gut microbiota between diabetic patients with and without hypertension.Notably,specific gut genera within the Clostridiales class of the Firmicutes phylum are negatively associated with the risk of hypertension in patients with diabetes.
作者
张晓帆
贾小芳
何宇纳
王惠君
苏畅
刘爱东
ZHANG Xiaofan;JIA Xiaofang;HE Yuna;WANG Huijun;SU Chang;LIU Aidong(National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Beijing 100050,China;不详)
出处
《中国预防医学杂志》
2025年第11期1337-1342,共6页
Chinese Preventive Medicine
基金
国家科技重大专项项目(2024ZD0531801)。
关键词
糖尿病
高血压
肠道菌群
共病
Diabetes mellitus
Hypertension
Gut microbiota
Comorbidity
