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术前肠道微生物群对老年骨科手术患者术后神经认知功能障碍的影响

Contribution of preoperative gut microbiota in postoperative neurocognitive dysfunction in elderly patients undergoing orthopedic surgery.

作者信息

Bi Jiangjiang, Xu Yifan, Li Shiyong, Zhan Gaofeng, Hua Dongyu, Tan Juan, Chi Xiaohui, Xiang Hongbing, Guo Fengjing, Luo Ailin

机构信息

Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Aging Neurosci. 2023 Feb 17;15:1108205. doi: 10.3389/fnagi.2023.1108205. eCollection 2023.

DOI:10.3389/fnagi.2023.1108205
PMID:36875700
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9981628/
Abstract

OBJECTIVE

To investigate the role of gut microbiota and metabolites in POCD in elderly orthopedic patients, and screen the preoperative diagnostic indicators of gut microbiota in elderly POCD.

METHOD

40 elderly patients undergoing orthopedic surgery were enrolled and divided into Control group and POCD group following neuropsychological assessments. Gut microbiota was determined by 16S rRNA MiSeq sequencing, and metabolomics of GC-MS and LC-MS was used to screen the differential metabolites. We then analyzed the pathways enriched by metabolites.

RESULT

There was no difference in alpha or beta diversity between Control group and POCD group. There were significant differences in 39 ASV and 20 genera bacterium in the relative abundance. Significant diagnostic efficiency analyzed by the ROC curves were found in 6 genera bacterium. Differential metabolites in the two groups including acetic acid, arachidic acid, pyrophosphate etc. were screened out and enriched to certain metabolic pathways which impacted the cognition function profoundly.

CONCLUSION

Gut microbiota disorders exist preoperatively in the elderly POCD patients, by which there could be a chance to predict the susceptible population.

CLINICAL TRIAL REGISTRATION

[http://www.chictr.org.cn/edit.aspx?pid=133843&htm=4], identifier [ChiCTR2100051162].

摘要

目的

探讨肠道微生物群及其代谢产物在老年骨科患者术后认知功能障碍（POCD）中的作用，筛选老年POCD患者术前肠道微生物群的诊断指标。

方法

纳入40例行骨科手术的老年患者，经神经心理学评估后分为对照组和POCD组。采用16S rRNA MiSeq测序法测定肠道微生物群，运用气相色谱-质谱联用（GC-MS）和液相色谱-质谱联用（LC-MS）代谢组学技术筛选差异代谢产物。随后分析代谢产物富集的通路。

结果

对照组和POCD组之间的α或β多样性无差异。相对丰度方面，39个可操作分类单元（ASV）和20个菌属存在显著差异。通过ROC曲线分析发现6个菌属具有显著诊断效能。筛选出两组间的差异代谢产物，包括乙酸、花生酸、焦磷酸等，并富集到某些对认知功能有深远影响的代谢通路。

结论

老年POCD患者术前存在肠道微生物群紊乱，借此有可能预测易感人群。

临床试验注册

[http://www.chictr.org.cn/edit.aspx?pid=133843&htm=4]，标识符[ChiCTR2100051162]

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/cc96386cfab1/fnagi-15-1108205-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/2b6cf127398b/fnagi-15-1108205-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/7793cff8c600/fnagi-15-1108205-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/d619c572b387/fnagi-15-1108205-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/31f46fa68ddc/fnagi-15-1108205-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/6fb1e4838f23/fnagi-15-1108205-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/398f895b49bc/fnagi-15-1108205-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/cc96386cfab1/fnagi-15-1108205-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/2b6cf127398b/fnagi-15-1108205-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/7793cff8c600/fnagi-15-1108205-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/d619c572b387/fnagi-15-1108205-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/31f46fa68ddc/fnagi-15-1108205-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/6fb1e4838f23/fnagi-15-1108205-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/398f895b49bc/fnagi-15-1108205-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae1/9981628/cc96386cfab1/fnagi-15-1108205-g007.jpg

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