A Study On The Distribution Characteristics Of Intestinal Flora In Diabetic Foot Patients And Its Correlation

Objective:Diabetic foot(diabetic foot,DF)is a chronic complication of diabetes and one of the serious public health problems in today’s society.Previous studies have shown that the intestinal microflora disorder is associated with the occurrence and development of type 2diabetic foot,In this study applied 16 S r RNA gene sequencing technology,By observing the diabetic foot group(group A,n=32),the general diabetic group(Group B,n=51),the control group(Group C,n=12)the distribution characteristics of intestinal flora and their main clinical laboratory indicators in the three groups,To explore the influence of intestinal flora distribution characteristics on the main clinical biochemical indexes and the development of diabetic foot,To provide a new theoretical basis for the treatment of diabetic foot based on intestinal flora.Methods:In this study,using the method of a cross-sectional study,Patients admitted to the endocrinology department of our hospital from November 2020 to November 2021 were divided into three groups of study subjects,The first stool samples,fasting blood glucose,Hb A 1 c,and inflammatory indicators of the three groups were collected,Applying the 16 S r RNA gene sequencing technology,By taxonomic annotation of intestinal microflora species in the three groups from seven taxonomic levels of domain,phyla,class,order,family,genus and species,Species composition analysis,alpha diversity analysis,beta diversity analysis,species difference and marker species analysis and functional potential prediction were performed in the three groups by using QIIME2 and R software.Results:1.Fasting Blood Glucose(FBG)and Glycosylated Hemoglobin(Type A1c)in diabetic foot group and diabetic group were significantly higher than those in control group(P<0.05),and the blood glucose control in diabetic foot group was the worst.On the other hand,White Blood Cell(WBC),NEUT%9(NE%),C-Reactive Protein(CRP),Procalcitonin(PCT),Erythrocyte Sedimentation Rate(ESR)and other inflammatory indicators were significantly higher than those of the other two groups(P <0.05).2.Species composition analysis of the three groups: The dominant intestinal flora in the three groups were generally concentrated in Firmicutes,Bacteroidetes,Proteobacteria and actinomyces.In addition,the top 10 intestinal flora in the three groups were mainly composed of Bifidobacterium,Lactobacillus,Shigella,Eubacillus transmyxus,Streptococcus,Enterococcus,Coprococcus,Bacteroides,Coprolite and Rumen coccus.Compared with the other two groups,the species composition of diabetic foot group showed an increase of harmful bacteria and a decrease of beneficial bacteria.3.alpha diversity analysis: Although the species accumulation curve reflects the lack of subjects included in this study,the species sparse curve indicates that the sequencing amount of each sample can fully detect the diversity of the intestinal flora of the three groups of the subjects,and the species richness and diversity of the diabeticr foot samples are significantly smaller than that of the other two groups.4.beta diversity analysis:The results of the NMDS analysis further suggest that the differences between the diabetic foot groups were greater than the other two groups.5.Analysis of species differences and marker species:optimal / eubacterium,vibrio,budding bacteria,bifidobacterium,faalis,another bacteria,anaerobic stick,bacteria,platon’s faecium,lactobacillus species in three groups between groups,and the importance of the differences in decline,in the top bacteria may be the difference between group landmark species.In addition,the abundance of harmful bacteria such as Vibrio(especially Vibrio sulphurizing),coprococcus,and anaerobic claviculus in diabetic foot group increased compared with the other two groups,while the abundance of beneficial bacteria such as bifidobacterium,Akermania,Coprobiotic,and Lactobacillus decreased compared with the other two groups.It is worth noting that the abundance of beneficial bacteria in diabetic foot group was significantly higher than that in the other two groups.6.Prediction of functional potential of intestinal flora: Metabolic pathways of intestinal flora in the three groups were concentrated in biosynthesis related pathways,and compared with diabetic group,P261-PWY and PWY-5265 pathway units were up-regulated in diabetic foot group,among which the up-regulation of P261-PWY pathway in diabetic foot group was caused by the encoding of methanococcus.Conclusions:Compared with the other two groups,the richness and diversity of intestinal flora in the diabetic foot group were significantly reduced.In the diabetic foot group,the abundance of harmful bacteria such as Vibrio(especially Vibrio vulcanizing),coprococcus,and anaerobic claviculus increased,while the abundance of beneficial bacteria such as bifidobacterium,Ackermannia,Coprobiotic,and Lactobacillus decreased.It is suggested that the diabetic foot group has more disordered intestinal flora distribution characteristics.The distribution characteristics of intestinal flora in the diabetic group may lead to more metabolic disorders through changes in glucose metabolism,inflammatory response of the body and the abundance of some metabolic pathways.At the same time,it can also affect patients’ immunity and other factors,making patients with diabetic foot group more prone to foot infection and further accelerate or induce the occurrence and development of diabetic foot.