Study On Intestinal Flora Of Pregnant Women With Gestational Diabetes Mellitus In The Third Trimester

BackgroundGestational diabetes mellitus(GDM)refers to an abnormal glucose metabolism caused by pregnancy.The increase of blood glucose during pregnancy is closely related to the occurrence of adverse pregnancy outcomes.The etiology of GDM is complex and has not been fully elucidated through current studies.The pathogeny is considered to be a combination of genetic factors,insulin resistance,inflammatory cytokines,adipokines and environmental factors(such as high-fat diet).There are a large number of microorganisms in the human digestive tract,in which the intestinal flora plays a major role.The intestinal flora can be viewed as a huge endocrine organ that controls many pathways of human metabolism.In recent years,many studies have confirmed that intestinal microflora disorders play a related role in the pathogenesis of type 2 diabetes.GDM is a pregnancy specific complication,its glucose metabolism is different than normal.The correlation between pathogenesis of GDM and intestinal flora requires further study.ObjectiveTo investigate the diversity of intestinal flora in GDM patients in the third trimester,and find the intestinal flora with significantly different between GDM patients and healthy pregnant women.In order to provide a theoretical basis for treating GDM patients with probiotic drugs.Materials and methodweil52 pregnant women who established perinatal health care records in the Third Affiliated Hospital of Zhengzhou University from 2018 to 2019,at 28 weeks and above pregnant,were studied.23 of them were diagnosed as GDM(GDM group,n=23)and others were healthy pregnant women(NOR group,n=29).We collected 1g of stool samples from these pregnant women after signing an informed consent form.High-throughput sequencing of V4 region of bacterial 16S rRNA gene was performed using the Illumina HiSeq sequencing platform,and the results were analyzed by bioinformatics.Result1.There was no significant difference in age and gestational weeks between the GDM group and the NOR group(P?0.05).But the BMI,fasting blood glucose,2-hour postprandial blood glucose,and HbAlc in GDM group were significantly higher than those in NOR group(P<0.05).2.The alpha diversity of intestinal flora in GDM group was higher than that in NOR group,and the difference was statistically significant(P<0.05).3.The abundance of Bacteroidetes in GDM group was significantly lower than that in NOR group,but the abundance of Firmicutes was higher than that of NOR group,the difference was statistically significant(P<0.05).The ratio of Firmicutes/Bacteroidetes of GDM group(0.71)was significantly higher than that of NOR group(0.34).4.At the level of genus,the abundance of Blautia,Lachnospira,Ruminococcus and Coprococcus in GDM group were higher than that of NOR group,while the abundance of Sutterella was lower than that of NOR group.These differences were statistically significant(P<0.05).Conclusions1.The alpha diversity of intestinal flora of GDM patients in the third trimester is higher than that of healthy pregnant women with the same gestational weeks.2.Compared with healthy pregnant women in the third trimester,the abundance of Bacteroidetes in GDM patients was decreased,while the abundance of Firmicutes and the ratio of Firmicutes/Bacteroidetes were increased.3.Compared with healthy pregnant women in the third trimester,the abundance of Blautia,Lachnospira,Ruminococcus,and Coprococcus in GDM pregnants were significantly increased while that of Sutterella reduced.