肠道菌群与老年骨质疏松患者骨密度、骨代谢的相关性  

The correlations of intestinal flora with bone mineral density and bone metabolism in elderly patients with osteoporosis

作　　者：干佳玥 杨保同 赵大治[2] GAN Jia-yue;YANG Bao-tong;ZHAO Da-zhi(Department of Laboratory Medicine,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China;不详)

机构地区：[1]河南科技大学第一附属医院检验科,河南洛阳471000 [2]河南科技大学第一附属医院骨科,河南洛阳471000

出　　处：《广东医学》2022年第10期1259-1264,共6页Guangdong Medical Journal

基　　金：河南省医学科技攻关计划项目(20180203854)。

摘　　要：目的 探讨肠道菌群与老年骨质疏松患者骨密度、骨代谢的关系。方法 选择60例老年骨质疏松患者,根据是否发生肠道菌群失调将患者分为肠道菌群正常骨质疏松组(29例)和肠道菌群失调骨质疏松组(31例),另选择51例老年胃肠道疾病患者(肠道菌群失调无骨质疏松组)和60例体检肠道菌群正常无骨质疏松老人(对照组)。荧光定量PCR检测肠道菌群相对丰度,双能X线骨密度仪检测骨密度,酶联免疫吸附试验检测血清Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、骨碱性磷酸酶(B-ALP)、Ⅰ型前胶原氨基端前肽(PINP)水平。Pearson或Spearman相关分析肠道菌群与骨密度和β-CTX、B-ALP、PINP相关性,二元logistic回归分析肠道菌群与老年骨质疏松的相关性。结果 双歧杆菌、梭状芽胞杆菌、韦荣氏球菌相对丰度在对照组、肠道菌群正常骨质疏松组、肠道菌群失调无骨质疏松组、肠道菌群失调骨质疏松组依次降低(F=254.724、141.006、139.338,P<0.01),粪便拟杆菌、单形拟杆菌、多行拟杆菌、诺迪拟杆菌相对丰度依次升高(F=114.496、139.730、354.754、1 227.073,P<0.01)。骨密度、血清B-ALP、PINP水平在对照组、肠道菌群失调无骨质疏松组、肠道菌群正常骨质疏松组、肠道菌群失调骨质疏松组依次降低(F=152.316、25.390、124.455,P<0.01),血清β-CTX水平依次升高(F=166.962,P<0.01)。双歧杆菌、梭状芽胞杆菌、韦荣氏球菌相对丰度与骨密度、B-ALP、PINP呈正相关(r=0.741、0.805、0.812;0.762、0.809、0.821;0.749、0.796、0.763,P均<0.01),与β-CTX呈负相关(r=-0.749、-0.782、-0.766,P均<0.01),粪便拟杆菌、单形拟杆菌、多行拟杆菌、诺迪拟杆菌相对丰度与骨密度、B-ALP、PINP呈负相关(r=-0.752、-0.759、-0.801;-0.769、-0.763、-0.795;-0.803、-0.748、-0.762;-0.811、-0.748、-0.762,P均<0.01),与β-CTX呈正相关(r=0.750、0.749、0.769、0.758,P均<0.01)。糖尿病、肠道菌群失调是老年骨Objective To investigate the correlations of intestinal flora with bone mineral density and bone metabolism in elderly patients with osteoporosis.Methods A total of 60 elderly osteoporosis patients were selected and divided into intestinal flora normal with osteoporosis group(29 cases)and intestinal flora disorder with osteoporosis group(31 cases)according to whether intestinal flora disorder occurred.Another 51 elderly patients with gastrointestinal diseases(intestinal flora disorder without osteoporosis group)and 60 elderly patients with normal intestinal microflora without osteoporosis(control group)were selected.Relative abundance of fluorescent quantitative PCR was applied for the detection of intestinal flora.Dual-energy X-ray absorptiometry was applied for assessmentof bone density.Enzyme-linked immunosorbent assay was applied for assessment of the serum collagen typeⅠcarboxyl end peptideβspecial sequence(β-CTX),bone alkaline phosphatase(B ALP)and collagen typeⅠN-propeptide(PINP)level.Pearson or Spearman correlation was applied to analyze the correlations of intestinal flora withbone mineral density,β-CTX,B-ALP,PINP correlation.Binary Logistic regression was applied to analyze the correlation between intestinal flora and senile osteoporosis.Results The relative abundance of Bifidobacterium,Clostridium,and Veronsii were significantly reduced in the control group,intestinal flora normal with osteoporosis group,intestinal flora disorder without osteoporosis group,and intestinal flora disorder with osteoporosis group(F=254.724,141.006 and 139.338,P<0.01);while the relative abundance of Bacteroidetes faecalis,Bacteroidetes monoformis,Bacteroidetes polytropis and Bacteroidetes nodi were significantly increased(F=114.496,139.730,354.754,1227.073,P<0.01).Bone mineral density,serum B-ALP and PinP levels were significantly reduced in the control group,intestinal flora disorder without osteoporosis group,intestinal flora normal with osteoporosis group and intestinal flora disorder with osteoporosis group(F=152

关 键 词：肠道菌群 骨质疏松 骨密度 骨代谢 优势菌 

分 类 号：R446.5[医药卫生—诊断学] R681[医药卫生—临床医学]