社区老年高血压合并2型糖尿病病人衰弱程度与肠道微生物的关系  

Relationship between frailty degree and intestinal microbiome in elderly patients with hypertension complicated with type 2 diabetes mellitus in community

作　　者：张炳山[1] 郁洁[1] 杨颖[1] 王卓[1] 陆守荣[1] 陈蓉 陆文伟[4] 郁志明[2] 洪侃 ZHANG Bing-shan;YU Jie;YANG Ying;WANG Zhuo;LU Shou-rong;HONG Kan;YU Zhi-ming;CHEN Rong;LU Wen-wei(Department of Geriatrics,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Department of Cardiovascular Medicine,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China;Xin’an Community Health Centre of Wuxi,Wuxi 214111,China;Food Science College,Jiangnan University,Wuxi 214122,China)

机构地区：[1]南京医科大学附属无锡市人民医院老年医学科,江苏省无锡市214023 [2]南京医科大学附属无锡市人民医院心血管内科,江苏省无锡市214023 [3]无锡市新安社区卫生服务中心,江苏省无锡市214111 [4]江南大学食品学院,江苏省无锡市214122 [5]不详

出　　处：《实用老年医学》2022年第7期663-669,共7页Practical Geriatrics

基　　金：2020年无锡市“太湖人才计划”医疗卫生高层次人才高端人才项目;无锡市卫生健康委科研重大项目(Z202002);2021年江苏省老年健康科研项目(老年医学临床技术应用研究项目单位:LD2021016;老年医学临床技术应用研究项目带头人:LR2021020);江苏省干部保健课题(BJ21008)。

摘　　要：目的探讨社区老年高血压合并T2DM病人衰弱程度与肠道微生物的关系。方法对居住在无锡市新安社区181例高血压合并T2DM的老年居民进行横断面调查,根据Fried衰弱表型结果,将其分为对照组(无衰弱者,112例)、衰弱前期组(46例)和衰弱组(23例)。采用16S高通量测序技术检测所有病人的肠道微生物组成,比较不同衰弱程度老年高血压合并T2DM病人肠道微生物群组组成。结果社区老年高血压合并T2DM病人衰弱和衰弱前期的发生率分别为12.7%和25.4%。衰弱组与对照组年龄、糖尿病病程、合并症数量、用药数量、日常生活能力量表(ADL)评分、迷你营养评估简表(MNA-SF)评分、MoCA评分、社会支持评定量表(SSRS)评分、血清白蛋白水平差异均有统计学意义(P<0.05)。与对照组相比,衰弱组肠道微生物α多样性无明显改变,β多样性增加(P<0.05)。在门水平上,与对照组相比,衰弱组Actinobacteria相对丰度增加,Fusobacteria相对丰度减少,差异均有统计学意义(P<0.05)。在属水平上,与对照组相比,衰弱组的Bifidobacteria和Lactobacillus丰度增加,Adlercreutzia、Clostridium、Coprococcus、Faecalibacterium、Phascolarctobacterium、Roseburia、Turicibacter丰度减少(均P<0.05)。与衰弱前期组相比,对照组Eggerthella丰度减少(P<0.05),衰弱组的Lactobacillus丰度增加,Clostridium、Coprococcu、Eggerthella丰度减少(P<0.05或P<0.01)。衰弱组其他未归类细菌较衰弱前期组和对照组明显减少(P<0.05)。结论超过1/8的社区老年高血压合并T2DM病人存在衰弱,且衰弱病人的肠道微生物组成与非衰弱病人不同。Objective To investigate the relationship between intestinal microbes and frailty degree in the elderly patients with hypertension complicated with type 2 diabetes mellitus(T2DM)in community.Methods A cross-sectional survey of 181 elderly residents with hypertension complicated with T2DM was conducted in Xin’an Community of Wuxi.According to the result of Fried Frailty Phenotype,the patients were divided into the control group(112 patients presenting with non-frailty),pre-frailty group(46 cases)and frailty group(23 cases).16S high-throughput sequencing technology was used to detect the composition of intestinal microbiota,and the composition of intestinal microbiota were compared among the patients with different frailty degrees.Results The incidence rate of frailty and pre-frailty in the community elderly patients with hypertension complicated with T2DM was 12.7%and 25.4%,respectively.There were significant differences in age,course of diabetes,number of complications,varieties of medicine,the scores of Activity of Daily Living(ADL),mini-nutritional assessment short-form(MNA-SF),Montreal Cognitive Assessment(MoCA)and Social Support Rating Scale(SSRS),and the level of albumin between the control group and frailty group(P<0.05).Compared with the control group,theαdiversity of intestinal microbe was not changed significantly in frailty group,but theβdiversity was increased significantly(P<0.05).At the phylum level,the relative abundance of Actinobacteria increased,and the relative abundance of Fusobacteria decreased in frailty group compared with the control group(P<0.05).At the genus level,the abundance of Bifidobacteria and Lactobacillus increased,and the abundance of Adlercreutzia,Clostridium,Coprococcus,Faecalibacterium,Phascolarctobacterium,Roseburia and Turicibacter decreased in frailty group compared with the control group(all P<0.05);Compared with pre-frailty group,the abundance of Eggerthella in the control group decreased,the abundance of Lactobacillus in frailty group increased,and the abundance of C

关 键 词：肠道微生物 衰弱 高血压 2型糖尿病 16S高通量测序 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]