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1 型糖尿病和 MODY2 患儿与健康对照儿童的肠道微生物群在组成和功能上存在差异:一项病例对照研究。

Gut Microbiota Differs in Composition and Functionality Between Children With Type 1 Diabetes and MODY2 and Healthy Control Subjects: A Case-Control Study.

机构信息

Pediatric Endocrinology, Hospital Materno-Infantil, Málaga, Spain.

Clinical Management Unit of Endocrinology and Nutrition, Laboratory of the Biomedical Research Institute of Málaga, Virgen de la Victoria University Hospital, Universidad de Málaga, Málaga, Spain.

出版信息

Diabetes Care. 2018 Nov;41(11):2385-2395. doi: 10.2337/dc18-0253. Epub 2018 Sep 17.

Abstract

OBJECTIVE

Type 1 diabetes is associated with compositional differences in gut microbiota. To date, no microbiome studies have been performed in maturity-onset diabetes of the young 2 (MODY2), a monogenic cause of diabetes. Gut microbiota of type 1 diabetes, MODY2, and healthy control subjects was compared.

RESEARCH DESIGN AND METHODS

This was a case-control study in 15 children with type 1 diabetes, 15 children with MODY2, and 13 healthy children. Metabolic control and potential factors modifying gut microbiota were controlled. Microbiome composition was determined by 16S rRNA pyrosequencing.

RESULTS

Compared with healthy control subjects, type 1 diabetes was associated with a significantly lower microbiota diversity, a significantly higher relative abundance of , , , , and genera, and a lower relative abundance of , , , and . Children with MODY2 showed a significantly higher abundance and a lower and abundance. Proinflammatory cytokines and lipopolysaccharides were increased in type 1 diabetes, and gut permeability (determined by zonulin levels) was significantly increased in type 1 diabetes and MODY2. The PICRUSt analysis found an increment of genes related to lipid and amino acid metabolism, ABC transport, lipopolysaccharide biosynthesis, arachidonic acid metabolism, antigen processing and presentation, and chemokine signaling pathways in type 1 diabetes.

CONCLUSIONS

Gut microbiota in type 1 diabetes differs at taxonomic and functional levels not only in comparison with healthy subjects but fundamentally with regard to a model of nonautoimmune diabetes. Future longitudinal studies should be aimed at evaluating if the modulation of gut microbiota in patients with a high risk of type 1 diabetes could modify the natural history of this autoimmune disease.

摘要

目的

1 型糖尿病与肠道微生物群落的组成差异有关。迄今为止,尚未对年轻 2 型成年发病型糖尿病(MODY2)进行微生物组研究,MODY2 是糖尿病的一种单基因病因。本研究比较了 1 型糖尿病、MODY2 和健康对照者的肠道微生物群。

研究设计和方法

这是一项病例对照研究,纳入了 15 名 1 型糖尿病患儿、15 名 MODY2 患儿和 13 名健康儿童。控制了代谢控制和可能改变肠道微生物群的因素。通过 16S rRNA 焦磷酸测序确定微生物组组成。

结果

与健康对照组相比,1 型糖尿病患儿的微生物多样性显著降低, 、 、 、 、 和 属的相对丰度显著升高, 、 、 和 属的相对丰度显著降低。MODY2 患儿的 属丰度显著升高, 属和 属丰度显著降低。1 型糖尿病患儿促炎细胞因子和脂多糖增加,1 型糖尿病和 MODY2 患儿的肠道通透性(通过 zonulin 水平确定)显著增加。PICRUSt 分析发现 1 型糖尿病中与脂质和氨基酸代谢、ABC 转运、脂多糖生物合成、花生四烯酸代谢、抗原加工和呈递以及趋化因子信号通路相关的基因增加。

结论

1 型糖尿病的肠道微生物群在分类和功能水平上与健康受试者不仅不同,而且与非自身免疫性糖尿病的模型根本不同。未来的纵向研究应旨在评估在 1 型糖尿病高危患者中调节肠道微生物群是否可以改变这种自身免疫性疾病的自然病程。

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