摘要
目的对糖尿病患者肠道菌群特征及其相关性进行系统评价。方法检索知网、维普、万方、PubMed、Cochrane library、Embase等数据库关于糖尿病患者肠道菌群特征及其相关性的文献,同时追踪纳入文献的参考文献,时限为2009年3月至2019年3月,采用统一提取表,由两名研究者独立按照规定的纳入排除标准进行文献提取和方法学质量评估。最后采用RevMan 5.3软件进行Meta合并,Stata 12.0软件进行亚组分析与发表性偏倚识别。结果共纳入25篇研究,合计2209例患者。Meta分析显示:(1)糖尿病患者菌群总量(SMD=-0.30,P=0.53)、乳杆菌数量(SMD=-0.79,P=0.20)下降,拟杆菌数量(SMD=1.43,P=0.12)、梭菌数量(SMD=0.28,P=0.40)增加,差异均无统计学意义,双歧杆菌数量(SMD=-1.82,P=0.02)下降,差异有统计学意义。(2)糖尿病患者菌群Shannon指数I2=91%,r=-0.21[-0.32,0.09],P<0.05;Chao1指数I2=0%,r=-28.17[-40.85,-15.48],P<0.05;均下降。(3)拟杆菌、双歧杆菌、梭菌与空腹血糖的相关性分别为:I2=0%,r=-0.15[-0.27,-0.03];I2=0%,r=-1.16[-1.42,0.91];I2=0%,r=-0.28[-0.42,-0.14],均P<0.05。而乳杆菌的相关性差异无统计学意义:I2=47%,r=-0.00[-0.30,0.29],P=0.98。(4)乳杆菌和拟杆菌与炎症因子(TNF-α、IL-6)呈负相关,乳杆菌(r=-0.43;r=-0.60),P<0.05;拟杆菌(r=-0.58;r=-0.58),P<0.05,差异有统计学意义。结论糖尿病患者肠道菌群总量无明显变化,但有益菌含量和多样性下降,拟杆菌、双歧杆菌和梭菌含量与血糖水平呈负相关,而乳杆菌无相关,其结果还需要大样本、高质量的研究加以论证。
Objective To evaluate the characteristics and correlation of intestinal flora in diabetic patients.Methods A search with time limit from March 2009to March 2019was conducted in CNKI,WanFang,VIP,PubMed,Cochrane library and Embase databases to assess the characteristics and correlation of intestinal flora in diabetic patients.The study tracked the selected literatures′references and used the same extraction table.The risk of bias in individual study and literature extraction work was assessed by two researchers independently.RevMan 5.3was used for Meta-analysis and Stata 12.0was used for subgroup analysis and publication bias identification.Results Twenty-five researches involving 2209patients were included in this study.Meta-analysis showed the following results:(1)There was no statistical significance in the decrease of total bacterial flora(SMD=-0.30,P=0.53),Lactobacillus(SMD=-0.79,P=0.20),the number of Bacteroidetes(SMD=1.43,P=0.12),and Clostridium(SMD=0.28,P=0.40)increased.However,the decrease of Bifidobacterium was statistically significant(SMD=-1.82,P<0.05).(2)Shannon index I2=91%,r=-0.21[-0.32,0.09],P<0.05;Chao1index I2=0%,r=-28.17[-40.85,-15.48],P<0.05;all decreased.(3)The correlation among Bacteroides,Bifidobacteria,Clostridium and fasting blood glucose:I2=0%,r=-0.15[-0.27,-0.03];I2=0%,r=-1.16[-1.42,0.91];I2=0%,r=-0.28[-0.42,-0.14];all P<0.05.However,the correlation of Lactobacillus was not statistically significant I2=47%,r=-0.00[-0.30,0.29],P=0.98.(4)The negative correlation between the two bacterial communities(Lactobacillus and Bacteroidetes)and the inflammatory factors(TNF-α,IL-6)was as follows(r=-0.43;r=-0.60),P<0.05;(r=0.58;r=-0.58),P<0.05,which was with statistically significant.Conclusion There is no obvious change in the total intestinal flora,but the content and diversity of beneficial bacteria decrease relatively.Bacteroides,Bifidobacteriumand Clostridiumare negatively correlated with blood glucose level.The change of Lactobacillus needs further confirm by large sample and high quality research.
作者
何雪冬
王芳
王瑶
肖月
吕显贵
易静
HE Xuedong;WANG Fang;WANG Yao;XIAO Yue;LYU Xiangui;YI Jing(School of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610032,China)
出处
《中国微生态学杂志》
CAS
CSCD
2020年第4期397-403,共7页
Chinese Journal of Microecology
基金
成都中医药大学附属医院/四川省中医院科技发展基金(y2019033)。
关键词
糖尿病
胃肠道微生物组
特征分布
相关性
系统评价
Diabetes mellitus
Gastrointestinal microbiome
Characteristic distribution
Correlation
Systematic review
