多囊肾病患者肠道真菌特征性改变及其与临床指标的相关性研究  

Changes in characteristics of gut fungal microbiota and their correlation with clinical indicators in patients with polycystic kidney disease

作　　者：侯占杰 戈宇松 唐波 雷媛媛 唐黎 蒋洪飞 简金呈 程金波 杨仕明 HOU Zhanjie;GE Yusong;TANG Bo;LEI Yuanyuan;TANG Li;JIANG Hongfei;JIAN Jincheng;CHENG Jinbo;YANG Shiming(Department of Gastroenterology,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,China;Department of Nephrology,Second Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,China)

机构地区：[1]陆军军医大学(第三军医大学)第二附属医院消化内科,重庆 [2]陆军军医大学(第三军医大学)第二附属医院肾内科,重庆

出　　处：《陆军军医大学学报》2025年第8期836-846,共11页Journal of Army Medical University

摘　　要：目的 研究多囊肾病(polycystic kidney disease,PKD)患者肠道真菌菌群多样性、组成结构及其与临床指标的相关性。方法 纳入2023年2月至2024年2月就诊于陆军军医大学第二附属医院的PKD患者44例、非多囊肾病慢性肾病(non-polycystic kidney disease chronic kidney disease,NPCKD)患者44例和健康对照者(health controls,HC)22例,基于ITS1 DNA测序技术分析受试者粪便样本肠道真菌组成,应用生物信息学方法比较各组间真菌的多样性和结构差异,并运用Pearson相关分析探讨肠道真菌与临床指标的相关性。结果 3组基线资料(性别、年龄、体质量指数等)差异无统计学意义,血清学指标(血肌酐、尿素氮、尿酸、估算肾小球滤过率等)存在统计学差异(P<0.01)。Alpha多样性分析显示,PKD组与HC组差异无统计学意义,与NPCKD组相比差异有统计学意义(P<0.01)。Beta多样性分析表明,3组间比较及两两比较均有统计学差异(P=0.001)。菌群结构分析发现,PKD组Candida(假丝酵母菌属)丰度显著高于其他2组(P<0.01),而Aspergillus(曲霉菌属)、Cladosporium(枝孢菌属)丰度显著低于HC组(P<0.05)。线性判别分析(LEFSe)表明PKD组中Candida显著富集,Aspergillus、Cladosporium显著减少。相关性分析显示,PKD组Cladosporium丰度与肾囊肿直径、免疫轻链Kappa/Lamda呈负相关(P<0.05),而Candida丰度与肝/肾囊肿直径呈正相关(P<0.01)。结论 PKD患者肠道真菌菌群多样性和组成结构存在特征性改变,Cladosporium和Candida与PKD患者的临床指标密切相关。Objective To investigate the diversity and composition of gut fungi microbiota in patients with polycystic kidney disease(PKD)and its correlation with clinical indicators.Methods A total of 44 PKD patients,44 patients with non-polycystic chronic kidney disease(NPCKD)and 22 healthy controls(HC)admitted to our hospital from February 2023 to February 2024 were recruited.ITS1 DNA sequencing was applied to analyze the gut fungal composition.Bioinformatics analysis was used to compare the diversity and structural differences of fungi among the 3 groups.Pearson correlation analysis was performed to analyze the relationship between gut fungi and clinical indicators.Results There were no significant differences in baseline characteristics(gender,age,body mass index,etc.)among the 3 groups,but statistical differences were seen in terms of serum indicators(such as serum creatinine,blood urea nitrogen,uric acid,estimated glomerular filtration rate,etc.)(P<0.01).Alpha diversity analysis showed no significant difference was seen between the PKD and HC groups,but the PKD group had significant differences to the NPCKD group(P<0.01).Beta diversity analysis revealed significant differences among the 3 groups and in pairwise comparisons(P=0.001).Fungi composition analysis found that the abundance of Candida was significantly higher in the PKD group than the other 2 groups(P<0.01),while the abundances of Aspergillus and Cladosporium were significantly lower in the PKD group than the HC group(P<0.05).Linear discriminant analysis(LEFSe)indicated that Candida was significantly enriched,while Aspergillus and Cladosporium were significantly reduced in the PKD group.Correlation analysis revealed that the abundance of Cladosporium was negatively correlated with cyst diameter and immunoglobulin light chain Kappa/Lambda ratio in the PKD group(P<0.05),while the abundance of Candida was positively correlated with liver/kidney cyst diameter(P<0.01).Conclusion PKD patients exhibit characteristic changes in gut fungi diversity and composition.The

关 键 词：多囊肾疾病 慢性肾脏病 真菌 ITS1 DNA 

分 类 号：Q939.5[生物学—微生物学] R322.45[医药卫生—人体解剖和组织胚胎学] R692.12[医药卫生—基础医学]