婴儿先天性高胰岛素血症行胰腺切除术术后的肠道微生物组特征。
Gut Microbiome Profile After Pancreatectomy in Infants With Congenital Hyperinsulinism.
机构信息
Division of Gastoenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA.
From the Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia.
出版信息
Pancreas. 2021 Jan 1;50(1):89-92. doi: 10.1097/MPA.0000000000001708.
OBJECTIVES
The objective of this study was to characterize gut microbiome profiles of infants with congenital hyperinsulinism (HI) who underwent near-total or partial pancreatectomy for hypoglycemia management, as compared with healthy controls.
METHODS
A prospective observational cohort study was performed. Subjects were infants (0-6 months) with HI who underwent removal of pancreatic tissue for management of intractable hypoglycemia from February 2017 to February 2018 at the Children's Hospital of Philadelphia. Fecal samples were collected postoperatively, on full enteral nutrition. The gut microbiome of HI subjects was analyzed and compared with age-matched samples from healthy infants.
RESULTS
Seven subjects with ≥50% pancreatectomy and 6 with <50% pancreatectomy were included. α (within-sample) diversity was lowest among infants with ≥50% pancreatectomy (richness: false discovery rate, 0.003; Shannon index: false discovery rate, 0.01). β (between-sample) diversity (Bray-Curtis dissimilarity, P = 0.02; Jaccard distance, P = 0.001) differed across groups (≥ or <50% pancreatectomy, controls). Bifidobacteria and Klebsiella species were least abundant among infants with ≥50% pancreatectomy but did not differ between infants with <50% pancreatectomy and historical controls.
CONCLUSIONS
Infants with HI who underwent ≥50% pancreatectomy differed from age-matched infants in gut microbiome profile, whereas those with <50% pancreatectomy more closely resembled control profiles. The durability of this difference should be investigated.
目的
本研究旨在比较接受全胰或部分胰切除术治疗低血糖的先天性高胰岛素血症（HI）婴儿与健康对照者的肠道微生物组特征。
方法
进行了一项前瞻性观察队列研究。研究对象为 2017 年 2 月至 2018 年 2 月期间因难治性低血糖在费城儿童医院接受胰腺组织切除以治疗 HI 的婴儿（0-6 个月）。术后患儿接受全肠内营养时收集粪便样本。分析 HI 患儿的肠道微生物组，并与健康婴儿的年龄匹配样本进行比较。
结果
纳入 7 例胰腺切除≥50%的患儿和 6 例胰腺切除<50%的患儿。胰腺切除≥50%的患儿内（within-sample）α 多样性最低（丰富度：假发现率，0.003；Shannon 指数：假发现率，0.01）。β（between-sample）多样性（Bray-Curtis 不相似性，P=0.02；Jaccard 距离，P=0.001）在各组（胰腺切除≥或<50%、对照组）之间存在差异。胰腺切除≥50%的患儿中双歧杆菌和克雷伯菌属的丰度最低，但与胰腺切除<50%的患儿和历史对照组之间无差异。
结论
与年龄匹配的婴儿相比，接受≥50%胰切除术的 HI 婴儿的肠道微生物组特征不同，而接受<50%胰切除术的婴儿与对照者的肠道微生物组特征更为相似。应进一步研究这种差异的持久性。
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