妊娠期糖尿病女性肠道菌群的变化特征及其与血糖、血脂和膳食的相关性  

Dynamic changes in gut microbiota of women with gestational diabetes mellitus and the correlation with blood glucose, blood lipid and diet

作　　者：王婕 吴慧 卢凌鹏 杨科峰 祝捷[6] 周恒益 姚蝶 高雅 冯宇婷 刘玉红 贾洁 WANG Jie;WU Hui;LU Lingpeng;YANG Kefeng;ZHU Jie;ZHOU Hengyi;YAO Die;GAO Ya;FENG Yuting;LIU Yuhong;JIA Jie(Department of Clinical Nutrition,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Clinical Nutrition,College of Health Science and Technology,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Nutrition,Shanghai Seventh People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Department of Medical Laboratory,Shanghai Seventh People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;School of Family and Consumer Sciences,Texas State University,San Marcos 78666,America;Department of Obstetrics and Gynecology,Shanghai Seventh People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海交通大学医学院附属新华医院临床营养科,上海200092 [2]上海交通大学医学院医学技术学院临床营养系,上海200025 [3]上海中医药大学附属第七人民医院营养科,上海200137 [4]上海中医药大学附属第七人民医院医学检验科,上海200137 [5]上海交通大学医学院附属新华医院上海市小儿消化与营养重点实验室,上海200092 [6]School of Family and Consumer Sciences,Texas State University,San Marcos 78666 [7]上海中医药大学附属第七人民医院妇产科,上海200137

出　　处：《上海交通大学学报（医学版）》2022年第9期1336-1346,共11页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81501338);上海交通大学医学院大学生创新训练计划(S202010248405);上海中医药大学校级课题(2019LK042)。

摘　　要：目的·探索妊娠期糖尿病(gestational diabetes mellitus,GDM)女性在孕中期至孕晚期的肠道菌群变化特征,及其与膳食摄入、血糖及血脂水平的相关性。方法·2019年6月—2021年1月于上海中医药大学附属第七人民医院妇产科门诊招募定期产检的孕中期女性78人,其中GDM女性30人(GDM组)、健康妊娠女性48人(对照组)。收集并分析2组孕妇的人口学信息及血生化指标。采用半定量食物频率问卷对2组孕妇的膳食摄入情况进行比较。分别于孕中期、孕晚期收集2组孕妇的粪便样本,通过16S rRNA高通量测序比较孕中期、孕晚期的GDM组和对照组孕妇的肠道菌群特征和其相似性。通过Spearman相关性热图分析孕中期孕妇的肠道菌群丰度与环境因子(血生化指标、膳食摄入成分)的关联。结果·与对照组相比,GDM组孕妇的孕期增重较多(P=0.012)。在孕中期,GDM组孕妇的空腹血糖水平、口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)1 h和OGTT 2 h血糖水平、三酰甘油水平高于对照组,高密度脂蛋白和低密度脂蛋白水平低于对照组(均P<0.05)。孕期膳食摄入的结果显示,GDM组孕妇的脂肪摄入水平高于对照组(P=0.046)。从孕中期至孕晚期,GDM组和对照组孕妇的肠道菌群α-多样性、β-多样性间差异均无统计学意义。孕中期GDM组与孕晚期GDM组、孕中期对照组、孕晚期对照组的属水平菌群结构相似性最小,而孕晚期GDM组与对照组的菌属构成相似性最高。Spearman相关性热图的结果显示,丁酸球菌科(Butyricicoccaceae)的丰度与膳食纤维和蔬菜摄入水平呈正相关(r=0.365,P=0.024;r=0.469,P=0.003),克雷伯菌(Klebsiella)的丰度与三酰甘油水平呈正相关(r=0.329,P=0.044),双歧杆菌(Bifidobacterium)的丰度与OGTT 2 h血糖水平呈负相关(r=-0.364,P=0.025)。结论·孕中期GDM组和对照组孕妇的肠道菌群组成较孕晚期存在较多显著差异物种,孕中期GDM相关的肠道�Objective·To explore the changes of gut microbiota in the women with gestational diabetes mellitus(GDM) during the second to the third trimesters of pregnancy, and the correlation with dietary intake and glucose-lipid metabolism. Methods·From June 2019 to January 2021, 78 pregnant women(30 GDM women in the GDM group and 48 healthy women in the control group) in the second trimester of pregnancy were recruited from the Department of Obstetrics and Gynecology of Shanghai Seventh People’s Hospital,Shanghai University of Traditional Chinese Medicine. Demographic information and blood biochemical indicators of the two groups were collected and analyzed. A semi-quantified Food-Frequency Questionnaire(FFQ) was used to compare the dietary intake of the two groups of pregnant women. Fecal samples were collected in both groups at the second and the third trimesters of pregnancy, respectively.The characteristics and similarities of gut microbiota in both groups at the second and the third trimesters were compared by 16S r RNA high-throughput sequencing. Spearman correlation heatmap was used to analyze the relation between the abundance of gut microbiota and environmental factors(blood biochemical indicators and dietary intake components) in the pregnant women at the second trimester.Results·Compared with the control group, the women in the GDM group gained more weight during pregnancy(P=0.012). In the second trimester, compared with the control group, the fast blood glucose level, the blood glucose level at oral glucose tolerance test(OGTT) 1 h and 2 h, and the triacylglycerol level of the pregnant women in the GDM group were higher, and the high-density lipoprotein and the low-density lipoprotein levels were lower(all P<0.05). The results of dietary intake during pregnancy showed that the fat intake level of the pregnant women in the GDM group was higher than that in the control group(P=0.046). From the second to the third trimester of pregnancy, there was no significant difference in the α-diversity and β-diversity

关 键 词：妊娠期糖尿病 肠道菌群 膳食 糖脂代谢 

分 类 号：R459.3[医药卫生—治疗学]