2型糖尿病患者的肠道菌群与阳明、太阴体质相关性分析

目的研究2型糖尿病患者的肠道菌群与阳明胃热、太阴脾虚体质相关性。方法选择符合纳入标准的新发2型糖尿病患者30例和健康者13例,结合《三阴三阳体质辨识量表》体质测评及计算机自动判读,将入组者分为阳明体质2型糖尿组、太阴体质2型糖尿病组、阳明体质健康组、太阴体质健康组,并收集粪便样本。将样本进行16s rDNA V3-4区测序,对四组患者肠道菌群进行Alpha多样性、可操作分类单元(OTUs)聚类、群落结构组成及物种差异分析。采用SPSS 20.0统计软件进行统计分析,进一步对Alpha多样性中的查奥指数(Chao)、艾斯指数(Ace)、多样性香农指数(Shannon)、辛普森指数(Simpson)进行秩和检验,以P<0.05为差异有统计学意义。运用发现高维生物标识和揭示基因组特征的软件LEfSe进行LDA分析,筛选出对样本划分产生显著性差异影响的群落。结果(1)阳明体质2型糖尿病患者、太阴体质2型糖尿病患者与阳明体质健康者、太阴体质健康者各组间菌群丰度Chao、Ace、Shannon、Simpson,无显著统计学差异(P>0.05);(2)四组的OTU相似性较高,但各组均有其特异的OTUs,其中糖尿病组阳明体质组为4个,糖尿病太阴体质组为11个;(3)四组的菌群结构组成是厚壁菌门、放线菌门、拟杆菌门、变形菌门;(4)太阴体质2型糖尿病组有11种显著升高的肠道菌群组分,阳明体质糖尿病组有2种显著升高的肠道菌群组分。阳明体质2型糖尿病患者的主要差异物种以厚壁菌门等为主,太阴体质2型糖尿病患者的主要差异物种以拟杆菌门等为主。结论2型糖尿病患者肠道菌群与阳明、太阴体质具有相关性。阳明、太阴不同体质2型糖尿病患者的肠道菌群存在差异,糖尿病患者肠道菌群变化可能是形成阳明、太阴体质差异的内在因素。

Correlation analysis between intestinal flora and constitutions of yangming and taiyin in patients with type 2 diabetes

Objective To investigate the correlation between intestinal flora and yangming-stomach heat and taiyin spleen deficiency in patients with type 2 diabetes.Methods 30 patients with newly developed type 2 diabetes and 13 healthy patients who met the inclusion criteria were selected.Combing the constitution measurement of‘constitution identification scale of tree yin and tree yang’with computer automatic interpretation,the participants were divided into the yangming constitution-type 2 glycosuria group,the taiyin constitution-type 2 diabetes group,the yangming constitution-health group and the taiyin constitution-health group,and feces samples were collected.The samples were sequenced in region v3-v4 of 16s rDNA.The intestinal flora of four group patients were analyzed by methods of Alpha diversity,operational taxon(OTUs)clustering,community structure composition and species difference analysis.SPSS 20.0 statistical software was used for statistical analysis,and the rank-sum test of Chao,Ace,Shannon and Simpson in Alpha diversity was further analyzed,P<0.05 was considered as statistically significant.LDA analysis was carried out by LEfSe,a software used to discover high-dimensional biological markers and reveal whole-genome features,and communities with significant differences in sample classification were screened out.Results There was no significant difference in the bacterial abundance of Chao,Ace,Shannon and Simpson,when yangming constitution-type 2 diabetes patients compared with t aiyin constitution-type 2 diabetes patients,and yangming constitution-healthy people compared with taiyin constitution-healthy people(P>0.05).The OTU of the 4 groups were similar,but each group had its specific OTUs,among which 4 were in yangming constitution-diabetes group and 11 were in taiyin constitution-diabetes group.The 4 groups were composed of firmicutes,actinomycetes,bacteroidetes and proteobacteria.There were 11 significantly increased intestinal flora components in the taiyin constitution-type 2 diabetes group,and 2 significantly increased intestinal flora components in the yangming constitution-type 2 diabetes group.The main species differences of yangming constitution-type 2 diabetes patients were firmicutes and so on,and the main species differences of taiyin constitution-type 2 diabetes patients were bacteroidetes and so on.Conclusion There was a correlation between intestinal flora and the constitutions of yangming and taiyin in patients with type 2 diabetes.There was difference between yangming constitution and taiyin constitution in patients with type 2 diabetes.The changes of intestinal flora in patients with type 2 diabetes may be a internal factor of forming yangming or taiyin constitution.