2型糖尿病合并肥胖患者膳食结构及肠道菌群结构的差异性

  目的   观察2型糖尿病（type 2 diabetes mellitus,T2DM）合并肥胖患者膳食结构及肠道菌群结构与健康人群的差异,为T2DM合并肥胖患者通过营养治疗重建肠道菌群提供依据。   方法   选取32例新诊断为T2DM合并肥胖的患者及32例健康人员分别作为观察组和对照组。收集两组研究对象1年内的食物摄入情况并运用主成分分析法比较2组人群膳食结构差异,同时采集粪便提取DNA后使用Illumina MiSeq高通量测序平台分析两组研究对象肠道菌群的结构和丰度差异。   结果   膳食结构方面,观察组的主要膳食结构特点是油脂摄入较多蔬菜摄入较少,而健康对照组则是一种主食、蔬菜、优质蛋白比例较均衡的膳食模式。肠道菌群分析结果:观察组粪便样本中菌群多样性降低,菌属Welch's t检验发现与膳食纤维消化相关的瘤胃球菌属（P < 0.001,FDR=0.037）、豆类消化相关的梭菌属（P < 0.001,FDR=0.014）及短链脂肪酸产生相关的布劳特菌属（P=0.042,FDR=0.049）丰度较健康人群降低。   结论   膳食结构不均衡及膳食纤维摄入不足可能通过影响肠道菌群的结构和丰度从而与T2DM合并肥胖的发生相关,提示T2DM合并肥胖组人群的营养治疗应重视膳食结构平衡和膳食纤维的补充。     

老年人群肠道菌群α多样性影响因素研究

  目的  研究老年人肠道菌群α多样性的影响因素。  方法  对社区老年人肠道菌群16Sr-DNA测序并分析菌群α多样性。按照四分位数将α多样性分为“高”和“低”两组，利用logistic回归分析模型分析肠道菌群α多样性的影响因素。  结果  多因素logistic回归分析模型分析结果显示，与最低三分位数组相比，精制谷物和水果摄入量最高三分位数组肠道菌群“高”Shannon指数OR(95% CI)值分别为0.57(0.36~0.89)和1.86(1.15~3.02)；较高频次酸菜/泡菜摄入者肠道菌群“高”Shannon指数OR(95% CI)值为0.47(0.27~0.81)。与Shannon指数类似，精制谷物、酸菜/泡菜和水果也是Simpson指数的影响因素，此外，性别也是Simpson指数的影响因素(P=0.028)。  结论  增加水果摄入有助于增加老年人肠道菌群α多样性，而精制谷物、酸菜/泡菜的摄入则可能不利于α多样性的增加。     

孤独症谱系障碍儿童与健康儿童粪便肠道菌群结构及短链脂肪酸的差异性研究

目的 分析孤独症谱系障碍(ASD)儿童与健康儿童粪便肠道菌群结构及短链脂肪酸变化差异,从肠道菌群角度为ASD的防治提供新思路。方法 选取2019年1—11月在江苏大学附属医院被诊断为ASD的25名儿童和同期体检的24名生长发育正常的健康儿童为研究对象,分别为ASD组和对照组。收集其粪便,采用16SrRNA测序分析肠道菌群结构;气相色谱法检测粪便短链脂肪酸含量。结果 与对照组比较,ASD组儿童肠道菌群丰富度(Chao1指数及Ace指数)及多样性(Shannon指数)显著降低,差异均有统计学意义(t=2.917、2.890、3.353,P<0.05);门水平上厚壁菌门、变形菌门丰度显著增高,拟杆菌门丰度明显降低,差异均有统计学意义(t=3.180、5.761、5.970,P<0.05);属水平上拟杆菌属、双歧杆菌属、布劳特氏菌属、链球菌属丰度显著降低,梭状芽胞杆菌属、萨特氏菌属丰度显著增加,差异均有统计学意义(Z=2.440、3.100、3.620、3.500、4.200、4.054,P<0.05);粪便短链脂肪酸中乙酸、丙酸及总短链脂肪酸含量显著增高,丁酸含量显著下降,差异均有统计学意义(t=3.040、3.220、2.560、4.100,P<0.05)。相关分析显示双歧杆菌属与丙酸及总短链脂肪酸呈负相关(r=-0.422、-0.412,P<0.05)。结论 ASD儿童粪便肠道菌群结构及短链脂肪酸含量发生明显改变,其中双歧杆菌属减少所致丙酸及总短链脂肪酸增高可能与ASD相关。     

婴幼儿肠道菌群与辅食添加状况的相关性研究

目的 探讨辅食添加种类及摄入营养素对耍幼儿肠道菌群及定植抗力的影响.方法 通过整群抽样对336名婴幼儿分5组进行3日膳食调查,并随机抽取55名母乳喂养儿进行粪便中双歧杆菌、乳酸杆菌、产气荚膜梭菌、拟杆菌、肠道杆菌培养测定;菌群定植抗力用粪便中双歧杆菌与肠杆菌数量的比值(B/E)表示.结果 婴幼儿肠道菌群总量在109cfu/g以上,拟杆菌属数量最高,其次为双歧杆菌属、肠杆菌、产气荚膜梭菌、乳酸菌属.肠道B/E值平均大于1.与肠道菌群及定植抗力有显著相关性或被多因素分析选入方程的膳食因素有辅食添加的豆类、蛋类、水果类食物及摄入的营养素辅食纤维、维生素、脂肪、碘、锰等,它们对提高肠道有益菌数量,促进肠道菌群平衡有很重要的作用.结论 应及时给婴儿添加优质的辅食,有利于促进儿童肠道有益菌的繁殖与菌群平衡.     

2型糖尿病患者与健康人之间肠道菌群的对比分析

目的分析青少年2型糖尿病患者与健康人之间肠道菌群的比较。方法选取2019年3月-2020年3月本院收治的20例青少年2型糖尿病患者作为观察组,另选取20例同期健康体检人员作为健康组。收集所有参与研究人员的当日粪便样品,提取细菌基因组DNA,利用细菌通用扩增引物分别实施PCR扩增随后实施克隆,在每个样本中选取30个阳性克隆,实施测序分析,将测序结果与数据库中数据进行对比鉴定,同时应对普雷沃氏菌属、双歧杆菌属以及拟杆菌属进行定量PCR。对比两组研究人员的菌种以及菌种数量。结果观察组的拟杆菌属、普氏菌属、灵芝菌属以及双歧杆菌属均多于健康组,而普雷沃氏菌则少于健康组(P<0.05);观察组双歧杆菌以及拟杆菌的定量PCR水平高于健康组(P<0.05)。结论青少年2型糖尿病患者与健康人之间的肠道菌群存在一定的差异,可见青少年2型糖尿病患者肠道菌群失调,这与血糖有一定关系,通过对比肠道菌群的差异能够为调节肠道菌群改善糖代谢提供依据。     

膳食脂肪摄入对女童初潮影响的前瞻性研究

  目的  探讨初潮前膳食总脂肪及不同类型脂肪酸摄入对女童初潮发生的前瞻性影响,为预防中国儿童青春期发育提前提供理论依据。  方法  利用“中国居民健康与营养调查(CHNS)”数据,选取1997—2015年有初潮信息且具有基线膳食调查数据并至少参与了一次随访调查的1 240名6~13岁女童为研究对象,采用Cox回归模型分析初潮前膳食总脂肪及脂肪酸摄入对女童初潮发生的前瞻性影响。  结果  调查对象的平均基线年龄为(8.3±1.8)岁。调整出生年代、居住地、家庭人均年收入水平、膳食能量摄入量及体质量指数Z评分(BMI SDS)后,膳食总脂肪及多不饱和脂肪酸(PUFA)摄入量最高组女童出现初潮提前的风险分别比最低组高30% 和34%[HR值(HR值95%CI)分别为1.30(1.01~1.68)、1.34(1.05~1.70)];未发现膳食饱和脂肪酸(SFA)、单不饱和脂肪酸(MUFA)摄入量与初潮发生的关联[HR值(HR值95%CI)分别为1.24(0.98~1.58)、1.25(0.97~1.62), P值均>0.05]。  结论  初潮前较高的膳食总脂肪及PUFA摄入可能导致女童初潮发生提前;未发现SFA及MUFA摄入与初潮发生的关联。     

1型糖尿病儿童肠道菌群谱分析研究

目的 通过16SrRNA基因测序方法探索1型糖尿病(T1DM)儿童肠道菌群结构变化的特征,并比较T1DM儿童与健康儿童间肠道菌群的差异,为临床应用益生菌进行TIDM早期干预提供理论基础和实验依据。方法 选取2018年10月-2019年10月在昆明市儿童医院内分泌遗传代谢科住院并初诊为T1DM的5~14岁儿童18例,同时选取19例性别、年龄相近的健康儿童为研究对象,收集两组儿童粪便标本后进行16SrRNA基因测序实验,并采用QIIME 2分析流程进行生物信息学分析,比较两组间肠道菌群的差异。结果 1)利用QIIME2软件将相似度100%的序列聚类分析后共获得3 248个Feature数;2)经物种鉴定及注释,绝大部分菌群都分类到属级和种级;3)Alpha多样性分析说明本次研究测序深度充分,并且T1DM儿童肠道菌群的丰富度及多样性较健康儿童降低 (P<0.05);4)Beta多样性分析中,PCoA图说明T1DM儿童和健康儿童间肠道菌群结构存在明显差异;5)肠道菌群组成差异分析中,在门水平上,T1DM儿童放线菌门、拟杆菌门和蓝细菌门丰度显著增高,而变形菌门、杆菌门的丰度降低(P<0.05);在属水平上,T1DM儿童粪杆菌属、双歧杆菌属和拟杆菌属的丰度较健康儿童增高,而埃希氏杆菌属-志贺氏杆菌、肠球菌属、Blautia菌属丰度降低(P<0.05)。结论 T1DM儿童存在肠道菌群生态失衡,并且菌群物种的丰富度及多样性降低。此外,T1DM儿童与健康儿童肠道菌群结构分布存在明显差异。     

1型糖尿病儿童肠道菌群谱分析研究

目的 通过16SrRNA基因测序方法探索1型糖尿病(T1DM)儿童肠道菌群结构变化的特征,并比较T1DM儿童与健康儿童间肠道菌群的差异,为临床应用益生菌进行TIDM早期干预提供理论基础和实验依据。方法 选取2018年10月-2019年10月在昆明市儿童医院内分泌遗传代谢科住院并初诊为T1DM的5~14岁儿童18例,同时选取19例性别、年龄相近的健康儿童为研究对象,收集两组儿童粪便标本后进行16SrRNA基因测序实验,并采用QIIME 2分析流程进行生物信息学分析,比较两组间肠道菌群的差异。结果 1)利用QIIME2软件将相似度100%的序列聚类分析后共获得3 248个Feature数;2)经物种鉴定及注释,绝大部分菌群都分类到属级和种级;3)Alpha多样性分析说明本次研究测序深度充分,并且T1DM儿童肠道菌群的丰富度及多样性较健康儿童降低 (P<0.05);4)Beta多样性分析中,PCoA图说明T1DM儿童和健康儿童间肠道菌群结构存在明显差异;5)肠道菌群组成差异分析中,在门水平上,T1DM儿童放线菌门、拟杆菌门和蓝细菌门丰度显著增高,而变形菌门、杆菌门的丰度降低(P<0.05);在属水平上,T1DM儿童粪杆菌属、双歧杆菌属和拟杆菌属的丰度较健康儿童增高,而埃希氏杆菌属-志贺氏杆菌、肠球菌属、Blautia菌属丰度降低(P<0.05)。结论 T1DM儿童存在肠道菌群生态失衡,并且菌群物种的丰富度及多样性降低。此外,T1DM儿童与健康儿童肠道菌群结构分布存在明显差异。     

孕早期蔬菜和水果摄入与肠道菌群的关系

目的 探讨成都市孕早期妇女蔬菜和水果摄入与肠道菌群组成及多样性之间的关系。方法 本研究纳入104例成都市孕早期妇女,使用膳食频率问卷收集其蔬菜和水果摄入情况,并分别依据蔬菜、水果摄入量中位数将孕早期妇女分为摄入量高组和摄入量低组。使用16S r RNA高通量测序检测孕早期妇女粪便样本肠道菌群,比较组间肠道菌群差异。采用多重线性回归探讨蔬菜、水果摄入和孕早期妇女肠道菌群的关系。结果 孕早期妇女蔬菜和水果摄入量中位数分别是90.0 g/d和200.0 g/d。孕早期蔬菜、水果摄入高低组孕早期妇女肠道菌群α多样性和β多样性无统计学差异。LEfSe分析显示,孕早期妇女多个肠道菌群的相对丰度在蔬菜、水果摄入量高低组间存在显著差异（P<0.01）。多重线性回归分析显示,在调整了年龄、孕前体质指数和能量摄入后,孕早期妇女蔬菜摄入量与Eubacterium siraeum group相对丰度呈正比（β=0.007, P=0.012）,与Bacteroides相对丰度呈反比（β=-0.167, P=0.023）;水果摄入量与Ruminococcus gnavus group相对丰度呈正比（β=0....     

天津市孤独症谱系障碍儿童膳食营养状况

  目的  调查分析天津市孤独症谱系障碍(ASD)儿童的膳食营养素摄入量和营养状况,为ASD儿童制定科学有效的营养干预措施提供依据。  方法  采用3 d 24h膳食回顾法调查天津市某特殊教育学校90名3~9岁ASD儿童24种膳食营养素的摄入情况,并对儿童进行体格测量。  结果  ASD儿童中超重肥胖儿童共31名,占34.4%;3名消瘦者占3.3%;1名生长迟缓者占1.1%。各年龄组ASD儿童维生素A、维生素B₁、维生素D、维生素B₆、叶酸、钙和碘的平均摄入量均低于推荐摄入量标准,铜、磷和锌的摄入量均高于推荐摄入量标准,其中有超过10%的ASD儿童铜和镁的摄入量超过可耐受最高摄入量。能量、脂肪、维生素A摄入情况构成在正常、超重、肥胖组差异有统计学意义(χ2值分别为9.24,10.03,P值均 <0.05)。  结论  孤独症谱系障碍儿童超重、肥胖率较高,营养素缺乏与过量的现象同时存在,建议采取个性化的饮食营养干预方案。     

中国女童初潮年龄与碳水化合物及膳食纤维摄入的关系

目的 探索中国女童初潮前碳水化合物及膳食纤维摄入与初潮年龄的关系,为预防儿童性早熟提供有效干预措施.方法 由中国健康与营养调查数据库获取750名中国女童初潮前膳食信息及初潮年龄,建立多元线性回归及逻辑回归模型,分析女童初潮前膳食碳水化合物及膳食纤维摄入量对初潮年龄的影响,以碳水化合物供能比替代碳水化合物摄人量进行敏感性...     

Dietary Fiber Intake Alters Gut Microbiota Composition but Does Not Improve Gut Wall Barrier Function in Women with Future Hypertensive Disorders of Pregnancy

Pregnancy alters the inflammatory state, metabolic hormones, and gut microbiota composition. It is unclear if the lower abundance of dietary fiber-fermenting, short-chain fatty acid-producing bacteria observed in hypertension also occurs in hypertensive disorders of pregnancy (HDP). This study investigated the relationship between dietary fiber intake and the gut microbiota profile at 28 weeks gestation in women who developed HDP in late pregnancy (n = 22) or remained normotensive (n = 152) from the Study of PRobiotics IN Gestational diabetes (SPRING). Dietary fiber intake was classified as above or below the median of 18.2 g/day. Gut microbiota composition was examined using 16S rRNA gene amplicon sequencing. The gut permeability marker zonulin was measured in a subset of 46 samples. In women with future HPD, higher dietary fiber intake was specifically associated with increased abundance of Veillonella, lower abundance of Adlercreutzia, Anaerotruncus and Uncl. Mogibacteriaceae and higher zonulin levels than normotensive women. Fiber intake and zonulin levels were negatively correlated in women with normotensive pregnancies but not in pregnancies with future HDP. In women with normotensive pregnancies, dietary fiber intake may improve gut barrier function. In contrast, in women who develop HDP, gut wall barrier function is impaired and not related to dietary fiber intake.     

Habitual Dietary Fiber Intake,Fecal Microbiota,and Hemoglobin A1c Level in Chinese Patients with Type 2 Diabetes

High-fiber diet interventions have been proven to be beneficial for gut microbiota and glycemic control in diabetes patients. However, the effect of a low level of fiber in habitual diets remains unclear. This study aims to examine the associations of habitual dietary fiber intake with gut microbiome profiles among Chinese diabetes patients and identify differential taxa that mediated associations of dietary fiber with HbA1c level. Two cross-sectional studies and one longitudinal study were designed based on two follow-up surveys in a randomized trial conducted during 2015–2017. The study included 356 and 310 participants in the first and second follow-ups, respectively, with 293 participants in common in both surveys. Dietary fiber intake was calculated based on a 3-day 24-h diet recall at each survey and was classified into a lower or a higher group according to the levels taken based on the two surveys using 7.2 g/day as a cut-off value. HbA1c was assayed to assess glycemic status using a cut-off point of 7.0% and 8.0%. Microbiome was profiled by 16S rRNA sequencing. A high habitual dietary fiber intake was associated with a decrease in α-diversity in both the cross-sectional and longitudinal analyses. At the first follow–up, phylum Firmicutes and Fusobacteria were negatively associated with a higher dietary fiber intake (p < 0.05, Q < 0.15); at the second follow-up, genus Adlercreutzia, Prevotella, Ruminococcus, and Desulfovibrio were less abundant in patients taking higher dietary fiber (p < 0.05, Q < 0.15); genus Desulfovibrio and Ruminococcaceae (Unknown), two identified differential taxa by HbA1c level, were negatively associated with dietary fiber intake in both the cross-sectional and longitudinal analyses, and mediated the dietary fiber-HbA1c associations among patients taking dietary fiber ≥ 7.2 g/day (mediation effect β [95%CI]: −0.019 [−0.043, −0.003], p = 0.018 and −0.019 [−0.046, −0.003], p = 0.016). Our results suggest that habitual dietary fiber intake has a beneficial effect on gut microbiota in Chinese diabetes patients. Further studies are needed to confirm our results.     

Unique Habitual Food Intakes in the Gut Microbiota Cluster Associated with Type 2 Diabetes Mellitus

This cross-sectional study aimed to clarify the characteristic gut microbiota of Japanese patients with type 2 diabetes (T2DM) using t-distributed stochastic neighbor embedding analysis and the k-means method and to clarify the relationship with background data, including dietary habits. The gut microbiota data of 383 patients with T2DM and 114 individuals without T2DM were classified into red, blue, green, and yellow groups. The proportions of patients with T2DM in the red, blue, green, and yellow groups was 86.8% (112/129), 69.8% (81/116), 76.3% (90/118), and 74.6% (100/134), respectively; the red group had the highest prevalence of T2DM. There were no intergroup differences in sex, age, or body mass index. The red group had higher percentages of the Bifidobacterium and Lactobacillus genera and lower percentages of the Blautia and Phascolarctobacterium genera. Higher proportions of patients with T2DM in the red group used α-glucosidase inhibitors and glinide medications and had a low intake of fermented soybean foods, including miso soup, than those in the other groups. The gut microbiota pattern of the red group may indicate characteristic changes in the gut microbiota associated with T2DM in Japan. These results also suggest that certain diabetes drugs and fermented foods may be involved in this change. Further studies are needed to confirm the relationships among traditional dietary habits, the gut microbiota, and T2DM in Japan.     

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

Chronic inflammation plays a central role in the pathophysiology of various non-communicable diseases. Dietary interventions can reduce inflammation, in part due to their effect on the gut microbiome. This systematic review aims to determine the effect of dietary interventions, specifically fiber intake, on chronic inflammatory diseases and the microbiome. It aims to form hypotheses on the potential mediating effects of the microbiome on disease outcomes after dietary changes. Included were clinical trials which performed a dietary intervention with a whole diet change or fiber supplement (>5 g/day) and investigated the gut microbiome in patients diagnosed with chronic inflammatory diseases such as cardiovascular disease (CVD), type 2 diabetes (T2DM), and autoimmune diseases (e.g., rheumatoid arthritis (RA), inflammatory bowel disease (IBD)). The 30 articles which met the inclusion criteria had an overall moderate to high risk of bias and were too heterogeneous to perform a meta-analysis. Dietary interventions were stratified based on fiber intake: low fiber, high fiber, and supplemental fiber. Overall, but most pronounced in patients with T2DM, high-fiber plant-based dietary interventions were consistently more effective at reducing disease-specific outcomes and pathogenic bacteria, as well as increasing microbiome alpha diversity and short-chain fatty acid (SCFA)-producing bacteria, compared to other diets and fiber supplements.     

微生物相关基因富集分析法鉴定风湿病相关肠道微生物群

  目的  鉴定与类风湿关节炎(rheumatoid arthritis, RA)、系统性红斑狼疮(systemic lupus erythematosus, SLE)和强直性脊柱炎(ankylosing spondylitis, AS)相关的肠道微生物群。  方法  利用已发表的全基因组关联研究(genome-wide association study, GWAS)和肠道微生物群GWAS的总结数据,运用肠道微生物群相关基因富集分析(gene set enrichment analysis, GSEA)方法检测肠道微生物群和风湿病之间的关联。  结果  通过鉴定发现多个肠道微生物群均与三种风湿病相关(均有P＜0.05)。其中,瘤胃球菌属(Ruminococcaceae_UCG-009)与RA、SLE和AS均相关(均有P＜0.05);Intestinibacter属和发酵性厌氧梭菌潜在新物种(Candidatus_Soleaferrea)则与RA和SLE相关(均有P＜0.05)。  结论  部分肠道微生物群可能通过其代谢物的作用成为新的风湿病调节因子,这为揭示肠道微生物群在风湿病中的作用提供了新的线索。     

基于降秩回归的血脂相关膳食模式与糖尿病的关系

目的 探寻血脂相关膳食模式与糖尿病的关联,为糖尿病的膳食干预提供科学依据。方法 选取4 759名来自伊犁州霍城县的农村居民作为研究对象,通过问卷调查、体格检查及实验室检测收集研究对象的相关资料。通过降秩回归法提取血脂相关膳食模式;利用Pearson相关分析评估血脂相关膳食模式评分及各食物组摄入量与血脂的相关性;并通过logistic回归分析模型探寻血脂相关膳食模式与糖尿病患病风险之间的关联。结果 血脂相关膳食模式主要以小麦、畜肉和油炸面食摄入较多,而杂粮、蔬菜和水果等摄入较少为特征。血脂相关膳食模式与TC (r=0.296,P<0.001)、LDL-C(r=0.225,P<0.001)及TG(r=0.332,P<0.001)呈正相关,而与HDL-C(r=-0.237,P<0.001)呈负相关。logistic回归分析模型分析结果显示,调整混杂因素后,血脂相关膳食模式评分Q4组比Q1组的糖尿病患病风险增加99%(OR=1.99; 95%CI:1.47～2.68;P<0.001),且随着膳食模式评分增高,糖尿病患病风险具有升高的线性趋势(P_趋势