摘要
目的分析性早熟儿童肠道菌群结构特征,探寻肠道菌群与儿童性早熟之间的关系,探讨儿童性早熟与肥胖之间的联系。方法纳入2018年9月~2019年10月于江苏大学附属医院就诊的性早熟儿童,分为治疗前、后组,选择同期于笔者医院体检的单纯性肥胖儿童及体重指数(body mass index,BMI)正常的健康儿童分别为肥胖组及对照组,收集各组儿童新鲜粪便标本,应用16S rRNA高通量测序分析其肠道菌群结构特点,采用问卷调查的形式调查分析纳入研究的各组儿童饮食习惯,性早熟组住院按照临床路径管理完成性激素等检查。结果代表肠道菌群丰富度指数Ace指数,Chao1指数在性早熟治疗前组均明显低于对照组(P<0.05),而与肥胖组之间比较差异无统计学意义(P>0.05);性早熟治疗后组Ace指数及Chao1指数明显高于治疗前组,多样性指数Shannon指数比较,差异无统计学意义。对各组儿童肠道菌群门水平分布研究显示,性早熟治疗前组拟杆菌门丰富度较对照组明显升高,而厚壁菌门、放线菌门及疣微菌门丰富度明显下降(P<0.05),且与肥胖组比较差异无统计学意义。各组儿童肠道菌群属水平分布显示,性早熟治疗前组双歧杆菌属及乳杆菌属等菌属丰富度较对照组明显下降,而拟杆菌属及普氏菌属等菌属丰富度明显升高(P<0.05),这些菌属丰富度与肥胖组比较,差异无统计学意义。主成分分析(principal component analysis,PCA)显示性早熟治疗前组肠道菌群与对照组菌群结构比较,差异有统计学意义。性早熟儿童及肥胖儿童在饮食方面更倾向于肉食及油炸类高热量食物,性早熟治疗前食反季水果概率明显高于肥胖组及正常组。结论性早熟儿童肠道菌群丰富度及多样性均明显下降,门及属水平菌群结构出现改变,提示肠道菌群结构紊乱可能是导致儿童性早熟发生的潜在因素,性早熟组与肥胖组儿童肠道菌群结构及饮食习惯均存在一定的相似性,为探究性早熟与肥胖之间潜在的发生机制再添新证。
Objective To analyze the structural characteristics of the intestinal flora in children with precocious puberty and explorethe relationship between the intestinal flora and precocious puberty,and the relationship between childhood precocious puberty and obesity d.Methods Children with precocious puberty were patients treated at the Affiliated Hospital of Jiangsu University from September 2018 to October 2019.They were divided into pre-treatment and post-treatment groups.Simple obese children and those with normal body mass index(BMI)who were examined in the hospital during the same period were selected as obese group and the control group respectively.Fresh fecal specimens of the children in each group were collected,and 16S rRNA high-throughput sequencing was used to analyze the structural characteristics of their intestinal flora.Questionnaires were used to investigate and analyze the diets of the children in each group included in the study.Precocious puberty group was hospitalized in accordance with clinical path management to complete the examinations of sex hormones and pituitary MRI.Results The Ace index,Chao1 index representing the intestinal flora richness and Shannon index representing diversity at the precocious puberty pre-treatment group were significantly lower than the control group(all P<0.05),and these three indexes had no significant difference as compared with the obesity group(all P>0.05).The Ace index and Chao1 index at the precocious puberty pre-treatment group were significantly lower than post-treatment groups.The phylum level of intestinal flora in each group showed that the abundance of Bacteroides in the precocious puberty treatment group was significantly higher than that in the control group,while the abundance of Firmicutes,Actinomycetes and Verrucomicrobial decreased significantly(all P<0.05),and there was no significant difference between the precocious puberty treatment group and obese group.The genus level of intestinal flora in each group of children showed that the abundance of Bifidobacterium and Lactobacillus in the precocious puberty treatment group were significantly lower than that in the control group,while the abundance of Bacteroides and Prevotella were significantly increased(all P<0.05).There was no significant difference in the abundance of these bacteria when compared with the obesity group.Principal component analysis(PCA)showed that the structure of the intestinal flora of the untreated precocious puberty group was significantly different from that of the normal control group.Children with precocious puberty and obese children tended to eat meat and fried high-calorie foods,and the dietary bias was more obvious.Conclusion The abundance and diversity of the intestinal flora in children with precocious puberty decreased significantly,and the flora structure of the phylum and genus level changed,suggesting that the disorder of the intestinal flora structure may be a potential factor leading to the occurrence of precocious puberty in children.The precocious puberty group and the obese group are similarities in the structure of flora and eating habits,which adds new evidence for exploring the underlying mechanism between precocious puberty and obesity.
作者
田佳梅
王锁英
金胜利
刘欢
王信超
边高瑞
TIAN Jiame;JIN Shengli;LIU Huan(People′s Hospital of Ningxia Hui Autonomous Region,Ningxia 750011,China)
出处
《医学研究杂志》
2022年第5期107-113,共7页
Journal of Medical Research
关键词
性早熟
肥胖
肠道菌群
Precocious puberty
Obesity
Intestinal flora
