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

Abstract

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

CLC Number:

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.

References

[1] MORLEY J E, VELLAS B, VAN KAN G A, et al. Frailty consensus: a call to action[J]. J Am Med Dir Assoc, 2013, 14(6):392-397.
[2] MITNITSKI A B, MOGILNER A J, ROCKWOOD K. Accumulation of deficits as a proxy measure of aging[J]. Sci World J, 2001, 1:323-336.
[3] 中国老年医学学会高血压分会, 国家老年疾病临床医学研究中心中国老年心血管病防治联盟. 中国老年高血压管理指南2019[J]. 中华老年多器官疾病杂志, 2019, 18(2):81-106.
[4] 国家老年医学中心, 中华医学会老年医学分会, 中国老年保健协会糖尿病专业委员会. 中国老年糖尿病诊疗指南(2021年版)[J]. 中华糖尿病杂志, 2021, 13(1):14-46.
[5] 张炳山, 郁志明, 洪侃. 衰弱与肠道微生物[J]. 实用老年医学, 2020, 34(6):617-619, 623.
[6] GOMAA E Z. Human gut microbiota/microbiome in health and diseases: a review[J]. Antonie Van Leeuwenhoek, 2020, 113(12):2019-2040.
[7] ODAMAKI T, KATO K, SUGAHARA H, et al. Age-related changes in gut microbiota composition from newborn to centenarian: a cross-sectional study[J]. BMC Microbiol, 2016, 16:90.
[8] KUNDU P, BLACHER E, ELINAV E, et al. Our gut microbiome: The Evolving Inner Self[J]. Cell, 2017, 171(7):1481-1493.
[9] SOYSAL P, STUBBS B, LUCATO P, et al. Inflammation and frailty in the elderly: a systematic review and meta-analysis[J]. Ageing Res Rev, 2016, 31:1-8.
[10] 中华医学会老年医学分会. 老年患者衰弱评估与干预中国专家共识[J]. 中华老年医学杂志,2017,36(3):251-256.
[11] 王琴, 代雪梅, 刘嘉琳, 等. 中国社区老年人衰弱发病及影响因素分析[J]. 南方医科大学学报, 2021, 41(11):1719-1724.
[12] BANA B, CABREIRO F. The microbiome and aging[J]. Annu Rev Genet, 2019, 53:239-261.
[13] ZHANG L, LIAO J, CHEN Q, et al. Characterization of the gut microbiota in frail elderly patients[J]. Aging Clin Exp Res, 2020, 32(10):2001-2011.
[14] MARGIOTTA E, MIRAGOLI F, CALLEGARI M L, et al. Gut microbiota composition and frailty in elderly patients with chronic kidney disease[J]. PLoS One, 2020, 15(4):e0228530.
[15] JACKSON M A, JEFFERY I B, BEAUMONT M, et al. Signatures of early frailty in the gut microbiota[J]. Genome Med, 2016, 8(1):8.
[16] CLAESSON M J, CUSACK S, O'SULLIVAN O, et al. Composition, variability, and temporal stability of the intestinal microbiota of the elderly[J]. Proc Natl Acad Sci U S A, 2011, 108(Suppl 1):4586-4591.
[17] VAN TONGEREN S P, SLAETS J P, HARMSEN H J, et al. Fecal microbiota composition and frailty[J]. Appl Environ Microbiol, 2005, 71(10):6438-6442.
[18] FORBES J D, CHEN C Y, KNOX N C, et al. A comparative study of the gut microbiota in immune-mediated inflammatory diseases-does a common dysbiosis exist? [J]. Microbiome, 2018, 6(1):221.
[19] WU L, ZENG T S, ZINELLU A, et al. A cross-sectional study of compositional and functional profiles of gut microbiota in Sardinian centenarians[J]. mSystems, 2019, 4(4):e00325-19.
[20] BIAGI E, FRANCESCHI C, RAMPELLI S, et al. Gut microbiota and extreme longevity[J]. Curr Biol, 2016, 26(11):1480-1485.
[21] GOLDSTEIN E J, TYRRELL K L, CITRON D M. Lactobacillus species: taxonomic complexity and controversial susceptibilities[J]. Clin Infect Dis, 2015, 60(Suppl 2):S98-S107.
[22] LI S J, ZHUO M, HUANG X, et al. Altered gut microbiota associated with symptom severity in schizophrenia[J]. PeerJ, 2020, 8:e9574.
[23] WANG F Q, JIANG H L, SHI K H, et al. Gut bacterial translocation is associated with microinflammation in end-stage renal disease patients[J]. Nephrology: Carlton, 2012, 17(8):733-738.
[24] HARAN J P, BUCCI V, DUTTA P, et al. The nursing home elder microbiome stability and associations with age, frailty, nutrition and physical location[J]. J Med Microbiol, 2018, 67(1):40-51.
[25] LIM M Y, HONG S, KIM J H, et al. Association between gut microbiome and frailty in the older adult population in Korea[J]. J Gerontol A Biol Sci Med Sci, 2021, 76(8):1362-1368.
[26] FERREIRA-HALDER C V, FARIA A V S, ANDRADE S S. Action and function of Faecalibacterium prausnitzii in health and disease[J]. Best Pract Res Clin Gastroenterol, 2017, 31(6):643-648.
[27] SEO B, JEON K, MOON S, et al. Roseburia spp. abundance associates with alcohol consumption in humans and its administration ameliorates alcoholic fatty liver in mice[J]. Cell Host Microbe, 2020, 27(1):25-40.e6.
[28] XU Y S, WANG Y H, LI H W, et al. Altered fecal microbiota composition in older adults with frailty[J]. Front Cell Infect Microbiol, 2021, 11:696186.
[29] WU M, YANG S J, WANG S Z, et al. Effect of berberine on atherosclerosis and gut microbiota modulation and their correlation in high-fat diet-fed ApoE-/- mice[J]. Front Pharmacol, 2020, 11:223.
[30] LANGSETMO L, JOHNSON A, DEMMER R T, et al. The association between objectively measured physical activity and the gut microbiome among older community dwelling men[J]. J Nutr Health Aging, 2019, 23(6):538-546.
[31] TRAN T T T, COUSIN F J, LYNCH D B, et al. Prebiotic supplementation in frail older people affects specific gut microbiota taxa but not global diversity[J]. Microbiome, 2019, 7(1):39.
[32] PONZIANI F R, PICCA A, MARZETTI E, et al. Characterization of the gut-liver-muscle axis in cirrhotic patients with sarcopenia[J]. Liver Int, 2021, 41(6):1320-1334.

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

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	GAO Yuan, CHEN Hua, CHEN Ke, HUANG Wenlong. Relationship of bone mineral density and fracture risk with type 2 diabetes mellitus-related factors in elderly patients [J]. Practical Geriatrics, 2024, 38(9): 911-915.
[2]	DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(9): 931-935.
[3]	LI Jingbing, WANG Huijun, WANG Shaoying, ZHAO Can, WANG Lidi, CAO Yujiao. Impacts of pentoxifylline combined with lipoic acid intervention on physical function and quality of life in elderly patients with frailty syndrome [J]. Practical Geriatrics, 2024, 38(8): 812-815.
[4]	LAI Xiaoxing, CHEN Baoyu, LIU Xiaoxuan, LI Qi, ZHU Hongwei, HUO Xiaopeng. Effect of motor-cognitive dual task training on cognitive frailty in the elderly [J]. Practical Geriatrics, 2024, 38(8): 821-825.
[5]	DU Yutian, LIAO Xinyi, ZHANG Suqiong, SHI Lei, CHENG Daomei. Prevalence and influencing factors of sarcopenia in elderly patients with H-type hypertension [J]. Practical Geriatrics, 2024, 38(7): 665-668.
[6]	LUO Xing, LIANG Zhenling, DING Ling, HUANG Fang. Relationship of serum 25(OH) D, Hcy and prethrombotic state molecular markers with cognitive impairment in elderly patients with hypertension [J]. Practical Geriatrics, 2024, 38(7): 679-682.
[7]	SHAN Zhuzi, WANG Xuefei, WU Haidi, LIU Dongmei, JIANG Hua, TANG Wei, MO Yongzhen, CUI Yan. Study on the relationship between percentage of body fat and blood glucose fluctuation in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(7): 693-696.
[8]	SHI Wen, ZHU Ping, ZHOU Jie, YAN Ting, HUANG Yujie, YAN Yan. Effect of pancreatic kallidinogenase on mild cognitive impairment in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(6): 587-591.
[9]	GUO Chun, YI Mengting, ZONG Qianxing, ZHOU Yi, WU Haidi, MO Yongzhen. Development of a 6-month risk prediction model for hypoglycemia in elderly patients with type 2 diabetes mellitus: a longitudinal study [J]. Practical Geriatrics, 2024, 38(6): 592-597.
[10]	ZHU Bei, HANG Lejia, GAO Fei, YUAN Haichuan, ZHAO Weihong. Correlation of frailty with serum leptin and 25-hydroxyvitamin D in elderly hemodialysis patients [J]. Practical Geriatrics, 2024, 38(6): 603-606.
[11]	WANG Chao, CHEN Xiaojun. Influence of tropical climate on blood pressure, peripheral blood microRNA-146a and Hcy in elderly patients with essential hypertension from northeast China [J]. Practical Geriatrics, 2024, 38(5): 470-437.
[12]	KOU Xi, LIU Yonghong, DONG Wei,WANG Hua, WANG Baomei, GAO Yufang. Correlation between insulin-like growth factor-1 and frailty syndrome in hospitalized elderly patients [J]. Practical Geriatrics, 2024, 38(5): 474-437.
[13]	LIU Qianhui, YAO Zijun, HE Yuli, XU Yunfan, WU Jun. Effects of HbA1c level on cardiac structure and function in elderly patients with type 2 diabetes mellitus and chronic heart failure [J]. Practical Geriatrics, 2024, 38(5): 491-437.
[14]	LI Shuang, YUAN Xiaoli, JIANG Zhixia, YANG Xiaoling, ZHAO Xiaoling, LIANG Heting, WANG Chaoping. Association of self-reported visual and hearing impairment and their interaction with frailty in the elderly [J]. Practical Geriatrics, 2024, 38(4): 343-347.
[15]	TANG Yuan, DENG Shufang, HE Yongmei, DAI Yuxuan, LUO Jing. The status of health literacy and correlation with frailty in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(3): 255-259.