| Objective:The richness,evenness and community structure of the gut microbiota in non-obese children with adenotonsillar hypertrophy and non-obese children without adenotonsillar hypertrophy were measured,and the levels of liver indexes of the two groups were also measured.To explore whether adenotonsillar hypertrophy and pediatric sleep disordered breathing（PSDB）would change the structures of the gut microbiota,and provide a new orientation for the diagnosis and treatment of PSDB and its complications.Methods:In the experimental group,47 non-obese children with adenotonsillar hypertrophy were enrolled from May 2020 to November 2021.Their Sleep Clinical Scores（SCS）were all greater than or equal to 6.5 points.It can be clinically diagnosed as "PSDB".At the same time,16 children（SCS<6.5 points）without adenotonsillar hypertrophy treated in our department were enrolled as the control group.Stool samples and fasting blood samples（without any treatment）were collected from all children after admission.The gut microbiota of all subjects was analyzed using 16 S r RNA sequencing technology from OTU distribution,α diversity,β diversity,significant different bacteria between groups,relative abundance at phylum level,and functional prediction of intestinal flora.The determination of liver indexes in fasting blood was completed by the Clinical Laboratory.SPSS 22.0 and Graph Pad Prism 8.0 were used to test and analyze the basic information data,liver indexes and microbial diversity of the two groups.Results:1.There was no statistical difference in basic clinical information such as age,gender and BMI between the two groups.We detect significant difference in SCS in the experimental group compared to that in the control group.We found significant differences in the level of albumin,globulin,albumin/ globulin（A/G）,aspartate aminotransferase（AST）and alanine aminotransferase（ALT）between the two groups（P<0.05）.We detected no statistical significance in total protein,alkaline phosphatase,γ-glutamyltransferase（γ-GT）,prealbumin and lactate dehydrogenase between the two groups（P >0.05）.2.We detected significant differences in the OTU number and α diversity of the gut microbiome between the two group（P<0.05）.There was a statistical difference in βdiversity between the two groups.That is,the richness and evenness of the gut microbiome in the experimental group were higher than those in the control group,and there were significant differences in the composition of the microbial communities between the two groups.3.We detected significant differences in the relative abundance of Bacteroidetes and the relative abundance of Proteobacteria of the two groups（FDR-P <0.001）.Furthermore,the relative abundance of Bacteroidetes was negatively correlated with SCS and the relative abundance of Proteobacteria was positively correlated with SCS.The other two dominant bacteria,Firmicutes and Actinobacteria,showed no statistically significant difference between the two groups（Firmicutes P =0.506,Actinomycetes P=0.912）.4.PICRUSt software was used to predict the composition of known microbial gene function based on 16 S r RNA sequencing results.The predicted gene function or metabolic pathway was compared with COG database and KEGG,and the biological process mediated by intestinal flora in PSDB was obtained.Conclusion:1.Adenotonsillar hypertrophy was associated with changes in the richness,evenness and community structure of the gut microbiota,and the relative abundance of Proteobacteria was significantly positively correlated with SCS,suggesting that adenotonsillar hypertrophy changed the intestinal microflora and in turn,the intestinal microflora may play a role in the occurrence and development of PSDB.2.The globulin,AST and ALT in the experimental group is higher than that in the control group,albumin,A/G is lower than that in the control group,children with adenotonsillar hypertrophy exist potential damage to the liver.Whether the gut microbiota would be one of the mechanisms binding PSDB and non-alcoholic fatty liver disease needs to be further investigated.3.The changes of intestinal microflora in children with adenotonsillar hypertrophy have a certain significance for a comprehensive understanding of the mechanism of PSDB and related terminal diseases,and provide a new idea for the diagnosis and treatment of PSDB. |
