Department of Endocrinology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Front Endocrinol (Lausanne). 2023 Jan 23;13:1095438. doi: 10.3389/fendo.2022.1095438. eCollection 2022.
Chronic hypercortisolism leads to a phenotype resembling metabolic syndrome. We aimed to investigate the association between gut microbiota and metabolic abnormalities in endogenous hypercortisolism (Cushing's syndrome).
A total of 23 patients with Cushing's syndrome (18 female and 5 men, aged 47.24 ± 12.99 years) and 30 age-, sex-and BMI-matched healthy controls (18 female and 12 men, aged 45.03 ± 6.69 years) were consecutively recruited. Differences in gut microbiota and plasma short-chain fatty acid (SCFAs) concentrations between the Cushing's syndrome patients and controls were analyzed by 16S rRNA sequencing and gas chromatography-mass spectrometry (GC-MS).
Compared to the controls, the Simpson and Pielou indices of α diversity were dramatically decreased in Cushing's syndrome ( < 0.05). The gut microbiota community structure differed significantly between Cushing's syndrome patients and controls. Compared to controls, the bacterial communities of the Cushing's syndrome patients were enriched in and , and depleted in , including , , , , and . Spearman analysis demonstrated that HbA1c, SBP, DBP, and cortisol levels were significantly positively correlated with and , whereas negatively correlated with , etc. Cushing's syndrome patients also had a lower propionic acid concentration (0.151±0.054 0.205±0.032 µg/mL, =0.039) than controls. Furthermore, the level of propionic acid was negatively correlated with systolic pressure and cortisol levels (<0.05).
Gut microbiota dysbiosis and decreased propionic acid levels were observed in patients with Cushing's, suggesting that the gut microbiota may be a potential therapeutic intervention target to improve hypercortisolism-related metabolic abnormalities.
慢性皮质醇增多症导致类似于代谢综合征的表型。我们旨在研究内源性皮质醇增多症（库欣综合征）中肠道微生物群与代谢异常之间的关系。
共纳入 23 例库欣综合征患者（18 名女性和 5 名男性，年龄 47.24±12.99 岁）和 30 名年龄、性别和 BMI 匹配的健康对照者（18 名女性和 12 名男性，年龄 45.03±6.69 岁）。通过 16S rRNA 测序和气相色谱-质谱联用（GC-MS）分析库欣综合征患者和对照组之间肠道微生物群和血浆短链脂肪酸（SCFA）浓度的差异。
与对照组相比，库欣综合征患者的α多样性辛普森和皮尔洛指数显著降低（<0.05）。库欣综合征患者和对照组的肠道微生物群落结构存在显著差异。与对照组相比，库欣综合征患者的细菌群落中 和 显著富集， 等显著减少。Spearman 分析表明，HbA1c、SBP、DBP 和皮质醇水平与 和 呈显著正相关，而与 等呈显著负相关。库欣综合征患者的丙酸浓度也较低（0.151±0.054 vs 0.205±0.032 µg/mL，=0.039）。此外，丙酸水平与收缩压和皮质醇水平呈负相关（<0.05）。
库欣综合征患者存在肠道微生物群失调和丙酸水平降低，提示肠道微生物群可能是改善皮质醇增多症相关代谢异常的潜在治疗干预靶点。
