2型糖尿病患者膳食纤维摄入量与肠道菌群的关联——基于一项随机对照试验的数据再分析

目的  分析2型糖尿病患者膳食纤维摄入量与肠道菌群的关联, 发现相关差异菌群, 为改善患者日常饮食, 调节肠道菌群, 促进健康提供依据。方法  采用横断面研究设计, 以参与一项健康素养和体力活动干预随机对照试验的356名2型糖尿病患者为研究对象。总热能和膳食纤维摄入量基于3 d 24 h膳食调查数据和中国食物成分表计算。对粪便菌群DNA进行16S rDNA V4高变区测序, 采用Qiime2软件进行生物信息学分析。多变量线性回归模型(multivariate analysis by linear models, MaAsLin)方法和广义线性模型用于获得与膳食纤维摄入量有关的肠道菌群。结果  研究对象的膳食纤维摄入量处于较低水平, 中位摄入量(四分位间距)仅7.4(5.5, 9.7) g/d。未发现膳食纤维摄入量高低与肠道菌群Alpha多样性有关, 但基于Jaccard距离矩阵(PERMANOVA P=0.016)计算的Beta多样性在两组间差异有统计学意义。低膳食纤维摄入组有较高丰度的梭杆菌属(Fusobacterium)、柯林斯菌属(Collinsella)和普雷沃菌属(Prevotella), 而高膳食纤维摄入组则有较高丰度的黄体链球菌(Streptococcus Luteciae)、脆弱拟杆菌(Fragilis)和双歧杆菌属(Bifidobacterium)。结论  2型糖尿病患者膳食纤维摄入量与肠道菌群组成有关联。较低膳食纤维摄入量与高丰度的有害菌有关, 而较高摄入量与较高的双歧杆菌属丰度有关, 提示增加膳食纤维摄入可能对患者的肠道菌群和健康有积极作用。

Dietary fiber intake and gut microbiota in Chinese patients with type 2 diabetes: secondary data analyses of a randomized controlled trial

  Objective  To evaluate associations of dietary fiber intake with gut microbiota in Chinese patients with type 2 diabetes (T2DM).  Methods  A cross-sectional study was conducted among 356 T2DM patients participating in a randomized controlled trial of health literacy and exercise interventions.Total energy and dietary fiber intake were calculated based on the 3-day 24-hour diet recall data and Chinese Food Composition Table.Bacterial 16S rDNA V4 region was sequenced, and Qiime2 was used to conduct bioinformatics analyses.MaAsLin method and generalized linear model were applied to identify differential taxa associated with dietary fiber intake.  Results  Dietary fiber intake was at a low level in our subjects, with a median intake (IQR) of 7.4(5.5, 9.7) g/day.Beta diversity of fecal microbiota based on the Jaccard distance matrix (PERMANOVA P=0.016) were significantly different between groups with a higher or a lower dietary fiber intake, but no significant association was observed between Alpha diversity and dietary fiber intake.Fusobacterium, Collinsella and Prevotella were more abundant in patients with a lower dietary fiber intake, while Streptococcus Luteciae, Fragilis and Bifidobacterium were enriched in patients taking higher dietary fiber.  Conclusions  Dietary fiber intake is associated with gut microbiota composition in diabetes patients, with several harmful bacteria abundant in patients taking lower dietary fiber, and Bifidobacterium enriched in those taking higher dietary fiber.Our results suggest potential regulating effect of usual dietary fiber intake on gut microbiota in diabetes patients.