Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Sankara Nethralaya, 18 College Road, Chennai, 600 006, Tamil Nadu, India.
School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
BMC Microbiol. 2024 Sep 13;24(1):342. doi: 10.1186/s12866-024-03496-x.
To determine the association of gut microbiome diversity and sight-threatening diabetic retinopathy (STDR) amongst patients with pre-existing diabetes.
A cross-sectional study was performed, wherein 54 participants selected in total were placed into cases cohort if diagnosed with STDR and those without STDR but had a diagnosis of diabetes mellitus of at least 10-year duration were taken as controls. Statistical analysis comparing the gut microbial alpha diversity between cases and control groups as well as patients differentiated based on previously hypothesized Bacteroidetes/Firmicutes(B/F) ratio with an optimal cut-off 1.05 to identify patients with STDR were performed.
Comparing gut microbial alpha diversity did not show any difference between cases and control groups. However, statistically significant difference was noted amongst patients with B/F ratio ≥1.05 when compared to B/F ratio < 1.05; ACE index [Cut-off < 1.05:773.83 ± 362.73; Cut-off > 1.05:728.03 ± 227.37; p-0.016]; Chao1index [Cut-off < 1.05:773.63 ± 361.88; Cut-off > 1.05:728.13 ± 227.58; p-0.016]; Simpson index [Cut-off < 1.05:0.998 ± 0.001; Cut-off > 1.05:0.997 ± 0.001; p-0.006]; Shannon index [Cut-off < 1.05:6.37 ± 0.49; Cut-off > 1.05:6.10 ± 0.43; p-0.003]. Sub-group analysis showed that cases with B/F ratio ≥ 1.05, divided into proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME), showed decreased diversity compared to controls (B/F ratio < 1.05). For PDR, all four diversity indices significantly decreased (p < 0.05). However, for CSME, only Shannon and Simpson indices showed significant decrease in diversity (p < 0.05).
Based on clinical diagnosis, decreasing gut microbial diversity was observed among patients with STDR, although not statistically significant. When utilizing B/F ratio, the decreasing gut microbial diversity in STDR patients seems to be associated due to species richness and evenness in PDR when compared to decreasing species richness in CSME.
在患有糖尿病前期的患者中，确定肠道微生物多样性与威胁视力的糖尿病视网膜病变（STDR）之间的关联。
进行了一项横断面研究，总共选择了 54 名参与者，如果被诊断为 STDR，则将其纳入病例队列，如果没有 STDR，但患有至少 10 年糖尿病病史，则将其作为对照组。对病例组和对照组之间的肠道微生物 alpha 多样性进行了统计学分析，以及基于先前假设的拟杆菌/厚壁菌（B/F）比率进行了分析，最佳截断值为 1.05，以识别患有 STDR 的患者。
比较肠道微生物 alpha 多样性，病例组和对照组之间没有差异。然而，当比较 B/F 比率≥1.05的患者与 B/F 比率<1.05的患者时，观察到统计学显著差异; ACE 指数[截止值<1.05：773.83±362.73；截止值>1.05：728.03±227.37；p-0.016]；Chao1 指数[截止值<1.05：773.63±361.88；截止值>1.05：728.13±227.58；p-0.016]；辛普森指数[截止值<1.05：0.998±0.001；截止值>1.05：0.997±0.001；p-0.006]；香农指数[截止值<1.05：6.37±0.49；截止值>1.05：6.10±0.43；p-0.003]。亚组分析显示，B/F 比率≥1.05的病例组，分为增殖性糖尿病视网膜病变（PDR）和临床显著黄斑水肿（CSME），与对照组（B/F 比率<1.05）相比，多样性降低。对于 PDR，所有四个多样性指数均显著降低（p<0.05）。然而，对于 CSME，只有香农和辛普森指数显示多样性显著降低（p<0.05）。
根据临床诊断，在患有 STDR 的患者中观察到肠道微生物多样性降低，尽管没有统计学意义。当使用 B/F 比率时，与 CSME 中物种丰富度降低相比，STDR 患者的肠道微生物多样性降低似乎与物种丰富度和均匀度有关。
