School of Public Health, Southern Medical University, Guangzhou, China.
Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
Front Immunol. 2023 Mar 3;13:1097853. doi: 10.3389/fimmu.2022.1097853. eCollection 2022.
Metabolic disorders caused by intestinal microbial dysregulation are considered to be important causes of gestational diabetes mellitus (GDM). Increasing evidence suggests that the diversity and composition of gut microbes are altered in disease states, yet the critical microbes and mechanisms of disease regulation remain unidentified.
PubMed (National Library of Medicine, Bethesda, MD, USA), Embase (Elsevier, Amsterdam, the Netherlands), the Web of Science™ (Clarivate™, Philadelphia, PA, USA), and the Cochrane Library databases were searched to identify articles published between 7 July 2012 and 7 July 2022 reporting on case-control and controlled studies that analyzed differences in enterobacteria between patients with GDM and healthy individuals. Information on the relative abundance of enterobacteria was collected for comparative diversity comparison, and enterobacterial differences were analyzed using random effects to calculate standardized mean differences at a -value of 5%.
A total of 22 studies were included in this review, involving a total of 965 GDM patients and 1,508 healthy control participants. Alpha diversity did not differ between the participant groups, but beta diversity was significantly different. , , , and were the dominant bacteria, but there was no significant difference between the two groups. Qualitative analysis showed differences between the groups in the / ratio, , and , but these differences were not statistically different.
Enterobacterial profiles were significantly different between the GDM and non-GDM populations. Alpha diversity in patients with GDM is similar to that in healthy people, but beta diversity is significantly different. / ratios were significantly increased in GDM, and this, as well as changes in the abundance of species of and , may be responsible for changes in microbiota diversity. Although the results of our meta-analysis are encouraging, more well-conducted studies are needed to clarify the role of the gut microbiome in GDM. The systematic review was registered with PROSPERO (https://www.crd.york.ac.uk/prospero/) as CRD42022357391.
肠道微生物失调引起的代谢紊乱被认为是妊娠糖尿病（GDM）的重要原因。越来越多的证据表明，疾病状态下肠道微生物的多样性和组成发生了改变，但关键的微生物和疾病调节机制仍未确定。
检索 2012 年 7 月 7 日至 2022 年 7 月 7 日期间在 PubMed（美国国立医学图书馆，贝塞斯达）、Embase（爱思唯尔，阿姆斯特丹）、Web of ScienceTM（科睿唯安，费城）和 Cochrane Library 数据库上发表的病例对照和对照研究报告，分析 GDM 患者与健康个体之间肠杆菌差异的文章。收集肠杆菌相对丰度的信息进行比较多样性比较，并使用随机效应分析肠杆菌差异，计算值为 5%的标准化均数差异。
本综述共纳入 22 项研究，共纳入 965 例 GDM 患者和 1508 例健康对照者。两组参与者的 alpha 多样性无差异，但 beta 多样性有显著差异。在门水平上，厚壁菌门和拟杆菌门是主要细菌门，但两组间无显著差异。在属水平上， 、 、 、 和 是优势菌属，但两组间无显著差异。定性分析显示两组间的 / 比值、 、 和 存在差异，但差异无统计学意义。
GDM 患者与非 GDM 人群的肠杆菌谱有显著差异。GDM 患者的 alpha 多样性与健康人群相似，但 beta 多样性差异显著。GDM 中 / 比值显著升高，这与 和 属物种丰度的变化可能导致微生物多样性的变化。虽然我们的荟萃分析结果令人鼓舞，但需要更多设计良好的研究来阐明肠道微生物组在 GDM 中的作用。系统评价已在 PROSPERO（https://www.crd.york.ac.uk/prospero/）上注册，注册号为 CRD42022357391。
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