肠道菌群及其代谢产物短链脂肪酸与中老年高血压人群心血管风险水平的相关性研究

doi:10.3969/j.issn.1006-3110.2023.01.011

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摘要目的研究不同心血管风险水平的中老年高血压患者肠道菌群的差异,为了解肠道菌群在高血压人群心血管疾病中的作用提供参考。方法选取2021年1—12月在四川省达州市人民医院消化内科就诊的中老年高血压患者,在低、中、高心血管风险的高血压患者中分别抽取100例作为研究对象,同时选取100例健康查体人群为对照组。采集各组患者粪便并分离细菌DNA,经16s rDNA高通量测序比较心血管风险程度与肠道菌群的结构、丰度及多样性之间的关联,同时分析各组短链脂肪酸水平差异。结果 ①从研究对象中,获得542个分类操作单元(operational taxonomic units,OTU),不同组间特有OUT(χ²=0.287,P=0.963)比较差异无统计学意义;但是不同组间ACE(F=8.305,P<0.001)、Shannon指数(F=52.796,P<0.001)、Simpson指数(F=75.628,P<0.001)、Chao指数(F=5.250,P=0.002)比较差异有统计学意义。②在门的水平上,各组在拟杆菌门(F=5.639,P<0.001)、厚壁菌门(F=12.740,P<0.001)、变形菌门(F=12.209,P<0.001)和酸杆菌门(F=6.572,P<0.001)等的相对丰度差异有统计学意义;在属的水平上,各组在罗氏菌属(F=28.936,P<0.001)、双歧杆菌属(F=15.668,P<0.001)和粪杆菌属(F=10.724,P<0.001)等菌属上差异有统计学意义。③Spearman相关性回归分析结果显示,乙酸水平与ACE(R²=0.410,P<0.01)、Shannon指数(R²=0.340,P<0.05)、Simpson指数(R²=0.574,P<0.01)和Chao指数(R²=0.544,P<0.01)呈正相关;丁酸水平与ACE(R²=0.681,P<0.01)、Shannon指数(R²=0.673,P<0.01)、Simpson指数(R²=0.695,P<0.01)呈正相关;戊酸平与ACE(R²=0.526,P<0.01)、Shannon指数(R²=0.419,P<0.05)、Simpson指数(R²=0.507,P<0.05)呈正相关。④相较于对照组,不同心血管风险组高血压患者肠道乙酸、丁酸、戊酸水平均有降低,且4组研究对象肠道乙酸(F=6.012,P<0.001)、丁酸(F=70.950,P<0.001)、戊酸(F=10.926,P<0.001)水平比较差异有统计学意义。结论本研究发现肠道菌群的多样性指数、均一性指数与高血压患者的心血管风险密切相关,肠道菌群可能通过代谢产物短链脂肪酸影响高血压患者的心血管风险,菌群疗法可能作为潜在的干预手段以对抗高血压患者的心血管风险。

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	覃雪
	白学松

关键词 ：肠道菌群, 高血压人群, 心血管风险, 短链脂肪酸, 相关性

Abstract：Objective To explore the differences in intestinal flora in middle-aged and elderly hypertensive patients with different levels of cardiovascular risk so as to provide references for understanding the role of intestinal flora in cardiovascular disease in hypertensive population. Methods We selected middle-aged and elderly hypertensive patients admitted to Department of Gastroenterology, the People’s Hospital of Dazhou City from January to December 2021. 300 study subjects were then selected from hypertensive patients at low, medium and high cardiovascular risk (each n=100), while 100 health check-up persons weresimultaneously chosen as the control group. Feces were collected from patients in each group and bacterial DNA was isolated. The associations between the degree of cardiovascular risk and the structure, abundance and diversity of intestinal flora were compared by 16s rDNA high-throughput sequencing, and the differences in short-chain fatty acids levels among the groups were also analyzed. Results A total of 542 taxonomic operational units (OTUs) were obtained in the study subjects, and the comparison of the unique OUT (χ²=0.287, P=0.963) between different groups was not statistically significant. However, the comparisons of ACE (F=8.305, P<0.001), Shannon index (F=52.796, P<0.001), Simpson index (F=75.628, P<0.001) and Chao index (F=5.250, P=0.002) were statistically significant when compared between groups. The groups showed statistically significant differences in the relative abundance of the Bacteroidetes (F=5.639, P<0.001), Bacillota (F=12.740, P<0.001), Pseudomonadota (F=12.209, P<0.001) and Acidobacteria (F=6.572, P<0.001). Moreover, the results showed statistically significant differences in the Rothia (F=28.936, P<0.001), Bifidobacterium (F=15.668, P<0.001) and Eubacterium faecalis (F=10.724, P<0.001). Spearman’s correlation regression analysis showed that acetic acid levels were positively correlated with ACE (R²=0.410, P<0.01), Shannon index (R²=0.340, P<0.05), Simpson index (R²=0.574, P<0.01) and Chao index (R²=0.544, P<0.01). Butyric acid levels were positively correlated with ACE (R²=0.681, P<0.01), Shannon index (R²=0.673, P<0.01) and Simpson index (R²=0.695, P<0.01). Valeric acid levels were positively correlated with ACE (R²=0.526, P<0.01), Shannon index (R²=0.419, P<0.05) and Simpson index (R²=0.507, P<0.05). Compared with the control group, intestinal acetic acid, butyric acid and valeric acid levels decreased in hypertensive patients in the different cardiovascular risk groups, and the differences in intestinal acetic acid (F=6.012, P<0.001), butyric acid (F=70.950, P<0.001) and valeric acid (F=10.926, P<0.001) levels were statisticallysignificant. Conclusion In this study, we found that the diversity index and homogeneity index of intestinal flora were closelyassociated with cardiovascular risk in the hypertensive patients, and intestinal flora may influence cardiovascular risk in thehypertensive patients through the metabolite short-chain fatty acids. The flora therapy may be a potential intervention to counteract cardiovascular risk in the hypertensive patients.

Key words： intestinal flora hypertensive population cardiovascular risk short-chain fatty acids correlation

收稿日期: 2022-08-22

R544.1

基金资助:四川省教育厅2018年科研项目(18ZA0218)

作者简介: 覃雪(1968-),女,四川宣汉人,本科,副教授,主要从事肠道菌群相关研究工作。

引用本文:

覃雪, 白学松. 肠道菌群及其代谢产物短链脂肪酸与中老年高血压人群心血管风险水平的相关性研究[J]. 实用预防医学, 2023, 30(1): 43-48. QIN Xue, BAI Xue-song. Correlation of intestinal flora and its metabolite short-chain fatty acids with cardiovascular risk levels in middle-aged and elderly hypertensive population. , 2023, 30(1): 43-48.

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https://www.syyfyx.com/CN/10.3969/j.issn.1006-3110.2023.01.011 或 https://www.syyfyx.com/CN/Y2023/V30/I1/43

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