| Objective:A large number of studies have shown that patients with type 2 diabetes have imbalance of intestinal flora,mainly manifested by an increase in Bacteroides and a decrease in Firmicutes bacteria,however,it has not been reported whether there are differences in intestinal flora among patients with type 2 diabetes at different glycated hemoglobin levels.The purpose of this study was to explore the differences of intestinal flora among different blood glucose levels in patients with type 2 diabetes.Methods:30 patients with type 2 diabetes who were admitted to the endocrinology department of The Second Hospital of Hebei Medical University between early April and the end of June 2019 were collected,and they were divided into 3 groups according to Hb A1 c levels,namely group A(Hb A1c7-9%)group B(Hb A1 c 9-11%),group C(Hb A1c>=11%).Analyze the results of FBG,HBA1 c,ALT,AST,CR,UA,BUN,TC,TG,HDL,LDL-c,TBA and the intestinal flora.Results:1.There was no significant difference in gender,age,SBP,DBP,du ration of T2 DM,BMI in group A,group B and group C(P>0.05).The average levels of Hb A1 c of the 3 groups were 7.32%,9.59% and 11.27%,respectively,and significant differences existed between any two gro ups(P<0.05).The average levels of FBG of group A,B and C were 8.07mmol/L,6.71mmol/L,10.76mmol/L.The average levels of Hb A1 c of t he 3 groups were 7.32%,9.59%,and 11.27%,respectively,and the pair wise comparisons between the three groups were significant(P<0.05);T he mean FBG of the 3 groups were 8.07 mmol/L,6.71 mmol/L,and 10.76 mmol/L,respectively.There were statistical differences among the 3 groups(PAC=0.021,PBC=0.001).2.The mean TBA of group A,group B and group C were 3.39?mol/L,2.25?mol/L,5.57?mol/L,and there was statistical difference between group B and C(PBC=0.010).3.There was no statistical difference in ALT,AST,CR,UA,BUN,TC,TG,HDL,and LDL-c among the three groups(P> 0.05).4.A total of 1,298,657 high-quality sequences were obtained from 30 fecal samples,with an average of 43,289 sequences per sample.The effective lengths of the sequences were 400-410 bp and 420-430 bp,accounting for 99.9% of the total effective sequences.The 30 bacteria with the highest abundance in the intestinal flora were analyzed.From group A to group B and group C,the abundance of microflora showed a gradually decreasing trend.At the phylum level,it was found that all samples were dominated by Bacteroides,,and Proteobacteria,among which Bacteroidea and Firmicutes were absolutely dominant.From group A to B and C,Bacteroides are increased,while Firmicutes are decreased;At the genus level,from group A to groups B and C,the abundance of Bacteroides increased,while that of Prevotella decreased gradually.However,the abundance of Firmicutes in group B was higher than in group A and C.At the species level,the abundance of bacteroideted in group C was higher than that in groups A and B.E.coli in groups B and C were higher than that in group A.F.prausnitzi in group B was higher than those in groups A and C.The abundance of Bifidobacterium and Akk were less in the three groups.5.Through alpha diversity analysis of the bacterial flora,it was found that there was no statistical difference in the diversity among the three groups.The ? diversity analysis showed that there was a certain clustering trend among the samples of each group,but the samples of each group were not completely separated,consideringthat it may be related to small samples and the wide inclusion criteria.6.Analyzing the differences of community structure of the 3 groups,shows that the differences among groups are not greater than the differences within groups(P>0.05),which may be related to the small sample size and wide inclusion criteria.Also,maybe there is no statistical difference among the 3 groups under the grouping condition.So further researches are needed to be conducted to explore whether differences are existed among patients with type 2 diabetes in different blood glucose levels.7.STAMP analysis of the samples at the genus level showed that the genus abundance of bacteroidetes in group A was significantly lower than that of group C(P<0.05).When we regarded group A and B as a big group to compare with group C,there were statistical differences existed between the 2 groups(P<0.05).Besides,When we regarded group B and C as a big group to compare with group A,there were statistical differences existed(P<0.05).When it comes to the abundance of anaerostipes and Coprococcus,it presents that the abundance of group A is lower than the other group(P<0.05)(the other group:group B plus group C).Conclusions:1.The intestinal flora of type 2 diabetic patients with different Hb A1 c levels is different.With the increase of Hb A1 c,the abundance of Bacteroidetes increases,while the abundance of Firmicutes decreases.2.The structure and abundance of the intestinal flora of patients with type 2 diabetes at different Hb A1 c levels is different,and the intestinal flora of patients with similar Hb A1 c levels tend to cluster. |
PDF Full Text Request