社区老年高血压合并2型糖尿病病人衰弱程度与肠道微生物的关系

doi:10.3969/j.issn.1003-9198.2022.07.005

实用老年医学 ›› 2022, Vol. 36 ›› Issue (7): 663-669.doi: 10.3969/j.issn.1003-9198.2022.07.005

社区老年高血压合并2型糖尿病病人衰弱程度与肠道微生物的关系

张炳山, 郁洁, 杨颖, 王卓, 陆守荣, 陈蓉, 陆文伟, 郁志明, 洪侃

214023 江苏省无锡市,南京医科大学附属无锡市人民医院老年医学科(张炳山,郁洁,杨颖,王卓,陆守荣);心血管内科(郁志明);
214111 江苏省无锡市,无锡市新安社区卫生服务中心(陈蓉);
214122 江苏省无锡市,江南大学食品学院(陆文伟)

收稿日期:2022-05-10 出版日期:2022-07-20 发布日期:2022-07-18
通讯作者: 洪侃,Email: 103028292@qq.com
作者简介:洪侃主任医师
基金资助:
2020年无锡市“太湖人才计划”医疗卫生高层次人才高端人才项目;无锡市卫生健康委科研重大项目(Z202002);2021年江苏省老年健康科研项目(老年医学临床技术应用研究项目单位LD2021016;老年医学临床技术应用研究项目带头人LR2021020);江苏省干部保健课题(BJ21008)

Relationship between frailty degree and intestinal microbiome in elderly patients with hypertension complicated with type 2 diabetes mellitus in community

ZHANG Bing-shan, YU Jie, YANG Ying, WANG Zhuo, LU Shou-rong, LU Wen-wei, YU Zhi-ming, HONG Kan

ZHANG Bing-shan, YU Jie, YANG Ying, WANG Zhuo, LU Shou-rong, HONG Kan. Department of Geriatrics; YU Zhi-ming. Department of Cardiovascular Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China;
CHEN Rong. Xin'an Community Health Centre of Wuxi, Wuxi 214111, China;
LU Wen-wei. Food Science College, Jiangnan University, Wuxi 214122, China

Received:2022-05-10 Online:2022-07-20 Published:2022-07-18

摘要/Abstract

摘要： 目的探讨社区老年高血压合并T2DM病人衰弱程度与肠道微生物的关系。方法对居住在无锡市新安社区181例高血压合并T2DM的老年居民进行横断面调查,根据Fried衰弱表型结果,将其分为对照组(无衰弱者,112例)、衰弱前期组(46例)和衰弱组(23例)。采用16S高通量测序技术检测所有病人的肠道微生物组成,比较不同衰弱程度老年高血压合并T2DM病人肠道微生物群组组成。结果社区老年高血压合并T2DM病人衰弱和衰弱前期的发生率分别为12.7%和25.4%。衰弱组与对照组年龄、糖尿病病程、合并症数量、用药数量、日常生活能力量表(ADL)评分、迷你营养评估简表(MNA-SF)评分、MoCA评分、社会支持评定量表(SSRS)评分、血清白蛋白水平差异均有统计学意义(P<0.05)。与对照组相比,衰弱组肠道微生物α多样性无明显改变,β多样性增加(P<0.05)。在门水平上,与对照组相比,衰弱组Actinobacteria相对丰度增加,Fusobacteria相对丰度减少,差异均有统计学意义(P<0.05)。在属水平上,与对照组相比,衰弱组的Bifidobacteria和Lactobacillus丰度增加,Adlercreutzia、Clostridium、Coprococcus、Faecalibacterium、Phascolarctobacterium、Roseburia、Turicibacter丰度减少(均P<0.05)。与衰弱前期组相比,对照组Eggerthella丰度减少(P<0.05),衰弱组的Lactobacillus丰度增加,Clostridium、Coprococcu、Eggerthella丰度减少(P<0.05或P<0.01)。衰弱组其他未归类细菌较衰弱前期组和对照组明显减少(P<0.05)。结论超过1/8的社区老年高血压合并T2DM病人存在衰弱,且衰弱病人的肠道微生物组成与非衰弱病人不同。

关键词: 肠道微生物, 衰弱, 高血压, 2型糖尿病, 16S高通量测序

Abstract: Objective To investigate the relationship between intestinal microbes and frailty degree in the elderly patients with hypertension complicated with type 2 diabetes mellitus (T2DM) in community. Methods A cross-sectional survey of 181 elderly residents with hypertension complicated with T2DM was conducted in Xin'an Community of Wuxi. According to the result of Fried Frailty Phenotype, the patients were divided into the control group (112 patients presenting with non-frailty), pre-frailty group (46 cases) and frailty group (23 cases). 16S high-throughput sequencing technology was used to detect the composition of intestinal microbiota, and the composition of intestinal microbiota were compared among the patients with different frailty degrees. Results The incidence rate of frailty and pre-frailty in the community elderly patients with hypertension complicated with T2DM was 12.7% and 25.4%, respectively. There were significant differences in age, course of diabetes, number of complications, varieties of medicine, the scores of Activity of Daily Living (ADL), mini-nutritional assessment short-form (MNA-SF), Montreal Cognitive Assessment (MoCA) and Social Support Rating Scale (SSRS), and the level of albumin between the control group and frailty group (P<0.05). Compared with the control group, the α diversity of intestinal microbe was not changed significantly in frailty group, but the β diversity was increased significantly (P<0.05). At the phylum level, the relative abundance of Actinobacteria increased, and the relative abundance of Fusobacteria decreased in frailty group compared with the control group (P<0.05). At the genus level, the abundance of Bifidobacteria and Lactobacillus increased, and the abundance of Adlercreutzia, Clostridium, Coprococcus, Faecalibacterium, Phascolarctobacterium, Roseburia and Turicibacter decreased in frailty group compared with the control group (all P<0.05); Compared with pre-frailty group, the abundance of Eggerthella in the control group decreased, the abundance of Lactobacillus in frailty group increased, and the abundance of Clostridium, Coprococcus and Eggerthella decreased in frailty group (P＜0.05 or P＜0.01); Other unclassified bacteria were significantly less in frailty group than those in pre-frailty group and the control group(P<0.05). Conclusions More than one eighth of the community elderly patients with hypertension complicated with T2DM present with frailty. The intestinal microbiome composition of the patients with frailty differs from that of the patients who don't have frailty.

Key words: intestinal microbiome, frailty, hypertension, type 2 diabetes mellitus, 16S high-throughput sequencing

中图分类号:

张炳山, 郁洁, 杨颖, 王卓, 陆守荣, 陈蓉, 陆文伟, 郁志明, 洪侃. 社区老年高血压合并2型糖尿病病人衰弱程度与肠道微生物的关系[J]. 实用老年医学, 2022, 36(7): 663-669.

ZHANG Bing-shan, YU Jie, YANG Ying, WANG Zhuo, LU Shou-rong, LU Wen-wei, YU Zhi-ming, HONG Kan. Relationship between frailty degree and intestinal microbiome in elderly patients with hypertension complicated with type 2 diabetes mellitus in community[J]. Practical Geriatrics, 2022, 36(7): 663-669.

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社区老年高血压合并2型糖尿病病人衰弱程度与肠道微生物的关系

Relationship between frailty degree and intestinal microbiome in elderly patients with hypertension complicated with type 2 diabetes mellitus in community

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