摘要
目的探讨妊娠期糖尿病(GDM)患者不同孕期肠道微生物和代谢产物水平变化及与胰岛素抵抗(IR)的关系。方法选取在安徽医科大学附属安庆市第一人民医院进行产检并计划在本院生产的120例GDM孕妇。分别于孕早期、孕中期、孕晚期采集粪便中段样本,应用16S rRNA法测定生物菌群分布以分析肠道微生物情况;采用液相色谱-串联质谱法检测粪便样本中氧化三甲胺(TMAO)及相关代谢产物;采用稳态模型计算胰岛素抵抗指数(HOMA-IR)和稳态模型评估β细胞功能指数(HOMA-β),并分析不同孕期肠道微生物和代谢产物水平变化及与IR的关系。结果孕早、中、晚期肠道拟杆菌属、栖粪杆菌属丰度依次降低,厚壁菌属、放线菌属丰度依次升高(P<0.05);孕早、中、晚期GDM患者肠道TMAO、TMA水平依次升高(P<0.05);孕早、中、晚期患者HOMA-IR依次升高,HOMA-β依次下降(P<0.05);拟杆菌属、栖粪杆菌属与HOMA-IR呈负相关,与HOMA-β呈正相关(P<0.05);厚壁菌属、放线菌属、TMAO、TMA与HOMA-IR呈正相关,与HOMA-β呈负关(P<0.05)。结论随着孕期进展,GDM患者肠道微生物及代谢产物水平紊乱会增加IR的发生风险。
Objective To investigate changes of gut microbes and metabolites in patients with gestational diabetes mellitus(GDM)at different stages of pregnancy,and their relationship with insulin resistance(IR).Methods A total of 120 pregnant women with GDM who underwent prenatal examination in Anqing First People's Hospital affiliated to Anhui Medical University and plan to produce in this hospital were included in this study.Fecal samples in the first,second and third trimester of pregnancy were collected respectively.16S rRNA method was used to determine the distribution of biological flora and to analyze the intestinal microbial situation.Liquid chromatography-tandem mass spectrometry was used to detect trimethylamine oxide(TMAO)and related metabolites in fecal samples.Insulin resistance index(HOMA-IR)was calculated sing steady-state model,and steady-state modelβcell function index(HOMA-β)was evaluated.Changes of intestinal microorganism and metabolite levels in different pregnancy stages and their relationship with insulin resistance were analyzed.Results The abundance of Bacteroides and Faecalibacterium decreased in order,while the abundance of Firmicutes and Actinobacteria increased in order from the first trimester,the second trimester to the third trimester(P<0.05).TMAO,TMA and HOMA-IR increased in order,while HOMA-beta decreased in order from the first trimester,the second trimester to the third trimester(P<0.05).In the third trimester of pregnancy,Bacteroides and Faecalibacterium were negatively correlated with HOMA-IR and positively correlated with HOMA-β(P<0.05).Firmicutes,Actinomycetes,TMAO and TMA were positively correlated with HOMA-IR and negatively correlated with HOMA-β(P<0.05).Conclusion With the progress of pregnancy,the disturbance of intestinal microorganisms and metabolites in pregnant women with GDM increases the risk of developing IR.
作者
祝淑平
马丽
叶晓林
顾俊菲
ZHU Shuping;MA Li;YE Xiaolin;GU Junfei(Department of Obstetrics and Gynecology,Anqing First People's Hospital Affiliated to Anhui Medical University,Anqing 246000,China;Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Wannan Medical College)
出处
《天津医药》
CAS
北大核心
2023年第6期624-627,共4页
Tianjin Medical Journal
基金
安徽省卫生健康委科研项目(AHWJ2021a003)。
关键词
糖尿病
妊娠
胃肠道微生物组
胰岛素抵抗
孕期
diabetes
gestational
gastrointestinal microbiome
insulin resistance
pregnancy periods
