成都地区中老年人糖、脂代谢异常与肠道菌群结构关系探究

目的 探索成都地区中老年人高血糖、血脂异常与其肠道菌群的种群结构之间的关系，寻找与糖脂代谢相关的重要菌群。方法 征集 110 名成都地区 45 岁及以上中老年人， 分为糖脂正常组、血脂异常组、高血糖组和双高组（同时患有血脂异常及高血糖），检测其血糖、血脂，并收集粪便样本采用高通量测序技术对肠道菌群的多样性、相对丰度差异及其与血糖血脂的相关性等进行分析。结果 （1）物种多样性:糖脂正常组肠道菌群Chao指数高于血脂异常组和高血糖组（F=3.67，P=0.016；F=3.58，P=0.018）。（2）菌群相对丰度差异:门水平上， 前五位菌门的相对丰度在各组间差异无统计学意义（P＞0.05）。属水平上， Roseburia 在糖脂正常组相对丰度高于血脂异常组（F=2.80，P=0.037），Phascolarctobacterium、 RombOTUsia 在糖脂正常组的相对丰度均高于高血糖组（F=3.34，P=0.024 ；F=2.94，P=0.032），Blautia、Ruminococcus torques、Dorea 在双高组相对丰度均高于高血糖组（F=2.78，P=0.038，F=2.82，P=0.034；F=3.89，P=0.011）。（3）血糖、血脂指标与菌群相对丰度的相关性:门水平上， 糖脂正常组 Actinobacteria与空腹血糖（Glucose ，GLU）负相关，高血糖组 Firmicutes 与总胆固醇（Total Cholesterol ，TC）、低密度脂蛋白胆固醇（Low-Density Lipoprotein Cholesterol ，LDL-C）正相关，双高组 Actinobacteria 与三酰甘油（Triglyceride ，TG）负相关， Verrucomicrobia 与 GLU 正相关而与 LDL 负相关。属水平上， Bifidobacterium 的相对丰度在糖脂正常组与 GLU 负相关，在血脂异常组与 TG 正相关，在双高组与 TG 负相关； Blautia 在血脂异常组与 LDL 负相关，高血糖组与高密度脂蛋白胆固醇（High density liptein cholesterol，HDL-C）正相关，双高组与 TC、HDL 正相关； Akkermansia在双高组中与 GLU 正相关而与 LDL 负相关。结论 患有血脂异常、高血糖的中老年人肠道菌群结构与糖脂正常人存在差异，但双高差异不明显，说明中老年人肠道菌群与中老年人血糖、血脂代谢的关系较为复杂，还需要进一步探索。

Exploring the relationship between abnormal glucose and lipidmetabolism and intestinal flora structure in middle-agedand elderly people,Chengdu

Objective To explore the relationship between hyperglycemia and dyslipidemia and the population structure of intestinal flora in middle-aged and elderly people in Chengdu, and to find the important flora related to glucolipid metabolism. Methods 110 middle-aged people aged 45 years or older in Chengdu were recruited and divided into normal glycolipids, dyslipidemia, hyperglycemia and double hyperglycemia groups, and their blood glucose and lipids were measured. We also collected stool samples to analyze the diversity and relative abundance of intestinal flora and its correlation with blood glucose and lipids using high-throughput sequencing technology. Results (1) Species diversity: Chao index of intestinal flora was higher in the normal glycolipids group than in the dyslipidemia and hyperglycemia groups (F=3.67，P=0.016；F=3.58，P=0.018). (2) Differences in relative abundance of bacterial groups: At the phylum level, the relative abundance of the top five phyla was not statistically significant among the groups (P＞0.05). At the genus level, the relative abundance of Roseburia in the normal glycolipids group was significantly higher than that in the dyslipidemia group (F=2.80, P=0.037), the relative abundance of Phascolarctobacterium and RombOTUsia in the normal glycolipids group was higher than that in the hyperglycemia group (F=3.34，P=0.024; F=2.94，P=0.032), and the relative abundance of Blautia, Ruminococcus torques and Dorea in the double high group was higher than that in the hyperglycemia group (F=2.78，P=0.038；F=2.82，P=0.034；F=3.89，P=0.011). (3) Correlation of blood glucose and lipid indexes with the relative abundance of Firmicutes: at the portal level, Actinobacteria in the normal glycolipids group were negatively correlated with fasting blood glucose (Glucose, GLU), Firmicutes in the hyperglycemic group were positively correlated with Total Cholesterol (TC) and Low-Density Lipoprotein Cholesterol (LDL-C), Actinobacteria in the double-high group were negatively correlated with Triacylglyceride (TG), Verrucomicrobia was positively correlated with GLU and negatively correlated with LDL. Verrucomicrobia was positively correlated with GLU and negatively correlated with LDL. At the genus level, the relative abundance of Bifidobacterium was negatively correlated with GLU in the normal glycolipids group, positively correlated with TG in the dyslipidemic group, and negatively correlated with TG in the double-high group; Blautia was negatively correlated with LDL in the dyslipidemic group, positively correlated with high density liptein cholesterol (HDL-C) in the hyperglycemic group, and positively correlated with TC and HDL in the double-high group; Akkermansia was positively correlated with GLU and negatively correlated with LDL in the double-high group. Akkermansia was positively associated with GLU and negatively associated with LDL in the double-high group. Conclusion The structure of intestinal flora in middle-aged and elderly people with dyslipidemia and hyperglycemia differ from those with normal glucose and lipids, but the double-high difference is not significant, indicating that the relationship between intestinal flora and glucose and lipid metabolism in middle-aged and elderly people is more complex and needs to be further explored.