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华南地区血脂异常患者经洗涤菌群移植治疗的效果。

Effect of Washed Microbiota Transplantation on Patients With Dyslipidemia in South China.

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.

Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China.

出版信息

Front Endocrinol (Lausanne). 2022 Apr 22;13:827107. doi: 10.3389/fendo.2022.827107. eCollection 2022.

Abstract

BACKGROUND AND AIMS

Although the manual crude fecal microbiota transplantation (FMT) reduces blood lipids in animal models of hyperlipidemia, its clinical effect on blood lipid metabolism in patients with hyperlipidemia and hypolipidemia remains unclear, especially in the Chinese population. It was reported that washed microbiota transplantation (WMT) was safer, more precise, and more quality-controllable than the crude FMT by manual. This study aimed to investigate the feasibility and effectiveness of WMT on lipid metabolism in the Chinese population.

METHODS

Clinical data of patients with various indications who received WMT for 1-3 treatment procedures were collected. Changes in blood lipids before and after WMT, namely, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), homeostasis model assessment of insulin resistance (HOMA-IR), liver fat attenuation, and liver stiffness measurement, were compared.

RESULTS

A total of 177 patients (40 cases of hyperlipidemia, 87 cases with normal blood lipids, and 50 cases of hypolipidemia) were enrolled in the First Affiliated Hospital of Guangdong Pharmaceutical University. WMT has a significant therapeutic effect in reducing blood lipid levels (TC and TG) in the short- and medium term in patients with hyperlipidemia (p <0.05). Hyper blood lipid decreased to normal in the short-term (35.14%; p <0.001), and LDL-C changed to normal in the medium term (33.33%; p = 0.013). In the hypolipidemia group, 36.36% and 47.06% changed to normal in the short-term (p = 0.006) and medium term (p = 0.005) of therapeutic effects based on blood lipid levels. In the normal blood lipid group and the low-risk group of atherosclerotic cardiovascular disease (ASCVD), the change was not statistically significant, indicating that WMT does not increase the risk of blood lipid and ASCVD in the long-term.

CONCLUSIONS

WMT treatment changes blood lipids in patients with hyperlipidemia and hypolipidemia without serious adverse events, with no risk for increasing blood lipids and ASCVD in the long-term. There were significant decreased TC, TG, and LDL-C levels in the medium term of WMT treatment for hyperlipidemia. Therefore, the regulation of gut microbiota by WMT may indicate a new clinical method for the treatment of dyslipidemia.

摘要

背景和目的

虽然手动粗制粪便微生物群移植(FMT)可降低高脂血症动物模型中的血脂,但其在高脂血症和血脂异常患者中的临床血脂代谢效果尚不清楚,尤其是在中国人群中。据报道,与手动的粗制 FMT 相比,经清洗的微生物群移植(WMT)更安全、更精确、更可控。本研究旨在探讨 WMT 对中国人群脂质代谢的可行性和有效性。

方法

收集了因各种适应证接受 1-3 次 WMT 治疗的患者的临床数据。比较了 WMT 前后的血脂变化,即总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、稳态模型评估的胰岛素抵抗(HOMA-IR)、肝脂肪衰减和肝硬度测量。

结果

共纳入广东药科大学第一附属医院 177 例(高脂血症 40 例、血脂正常 87 例、血脂异常 50 例)患者。WMT 可显著降低高脂血症患者短期和中期的血脂水平(TC 和 TG)(p<0.05)。短期内(35.14%;p<0.001)高胆固醇血症降至正常,中期(33.33%;p=0.013)LDL-C 正常化。在血脂异常组中,短期(p=0.006)和中期(p=0.005)疗效基于血脂水平,分别有 36.36%和 47.06%的患者转为正常。在血脂正常组和低危动脉粥样硬化性心血管疾病(ASCVD)组中,变化无统计学意义,提示 WMT 不会增加长期血脂和 ASCVD 的风险。

结论

WMT 治疗可改变高脂血症和血脂异常患者的血脂,无严重不良事件发生,长期不会增加血脂和 ASCVD 的风险。WMT 治疗高脂血症的中期 TC、TG 和 LDL-C 水平显著降低。因此,WMT 对肠道微生物群的调节可能预示着治疗血脂异常的一种新的临床方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc7f/9074302/5ca4a5d002f7/fendo-13-827107-g001.jpg

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