Endocrinology and Nutrition Department, Germans Trias i Pujol Hospital and Research Institute, Badalona, Spain.
School of Medicine, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
Front Endocrinol (Lausanne). 2023 Jun 5;14:1074757. doi: 10.3389/fendo.2023.1074757. eCollection 2023.
Patients with Cushing's disease (CD) in remission maintain an increased cardiovascular risk. Impaired characteristics of gut microbiome (dysbiosis) have been associated with several cardiometabolic risk factors.
Twenty-eight female non-diabetic patients with CD in remission with a mean ± SD) age of 51 ± 9 years, mean ( ± SD) BMI, 26 ± 4, median (IQR) duration of remission, 11(4) years and 24 gender-, age, BMI-matched controls were included. The V4 region of the bacterial 16S rDNA was PCR amplified and sequenced to analyse microbial alpha diversity (Chao 1 index, observed number of species, Shannon index) and beta diversity analysis through the Principal Coordinates Analysis (PCoA) of weighted and unweighted UniFrac distances. Inter-group difference in microbiome composition was analysed using MaAsLin2.
The Chao 1 index was lower in CD as compared with controls (Kruskal-Wallis test, q = 0.002), indicating lower microbial richness in the former. Beta diversity analysis showed that faecal samples from CS patients clustered together and separated from the controls (Adonis test, p<0.05). , a genus form of the Actinobacteria phylum was present in CD patients only, whereas , a genus from , was scarcely detectable/undetectable in CD patients as well as , a genus of the family of the phylum. In CS, the Chao 1 index was associated with fibrinogen levels and inversely correlated with both triglyceride concentrations and the HOMA-IR index (p<0.05).
Patients with CS in remission have gut microbial dysbiosis which may be one of the mechanisms whereby cardiometabolic dysfunctions persist after "cure".
缓解期库欣病（CD）患者仍存在心血管风险增加。肠道微生物群（失调）特征受损与多种心血管代谢危险因素相关。
纳入 28 名缓解期女性非糖尿病 CD 患者（平均年龄 ± SD 为 51 ± 9 岁，平均 BMI 为 26 ± 4，缓解期中位数（IQR）为 11（4）年）和 24 名性别、年龄、BMI 匹配的对照者。扩增和测序细菌 16S rDNA 的 V4 区，以分析微生物 α多样性（Chao1 指数、观察到的物种数、香农指数）和通过主坐标分析（PCoA）对加权和非加权 UniFrac 距离进行β多样性分析。使用 MaAsLin2 分析微生物组组成的组间差异。
CD 组的 Chao1 指数低于对照组（Kruskal-Wallis 检验，q = 0.002），表明前者的微生物丰富度较低。β多样性分析显示，CS 患者的粪便样本聚类在一起，与对照组分离（Adonis 检验，p<0.05）。仅在 CD 患者中存在属于放线菌门的 属，而在 CD 患者中几乎检测不到/无法检测到属于 目、 科的 属，也检测不到属于 门的 科的 属。在 CS 中，Chao1 指数与纤维蛋白原水平相关，与甘油三酯浓度和 HOMA-IR 指数呈负相关（p<0.05）。
缓解期 CS 患者存在肠道微生物失调，这可能是“治愈”后心血管代谢功能障碍持续存在的机制之一。
