高海拔地区藏族冠心病患者肠道菌群多态性研究

高中山; 任明; 马玉兰; 朱露露

doi:10.12290/xhyxzz.2021-0652

高海拔地区藏族冠心病患者肠道菌群多态性研究

Polymorphism of Gut Microbiota in High Altitude Tibetan Patients with Coronary Artery Heart Disease

摘要

摘要:
目的分析青藏高原藏族冠心病(coronary artery heart disease, CHD)患者肠道菌群的分布和组成特征。
方法 2018年9月至2020年9月, 连续招募世居青藏高原(海拔3600~4500 m)的藏族CHD患者高海拔藏族CHD患者(high altitude Tibetan CHD, HTC)和藏族健康人群高海拔藏族健康人群(high altitude Tibetan normal, HTN), 长期居住于西宁(海拔2260 m)的汉族CHD患者中海拔汉族CHD患者(middle altitude Han CHD, MHC)和武汉(海拔13 m)汉族CHD患者低海拔汉族CHD患者(low altitude Han CHD, LHC)。其中HTC与MHC均来自青海大学附属医院心内科住院患者, HTN均来自青海大学附属医院体检中心, LHC均来自华中科技大学附属协和医院心内科住院患者。收集研究对象粪便组织标本, 对肠道菌群16S rRNA V3~V4区进行DNA测序并进行生物信息学分析。
结果共入选符合纳入和排除标准的CHD患者36例(HTC 8例、MHC 14例、LHC 14例), HTN 34例。α多样性分析显示, HTC与HTN的肠道菌群Shannon指数无显著性差异(P=0.091);HTC的肠道菌群Shannon指数最高, MHC次之, LHC最低(P=0.025)。β多样性分析显示, HTC的肠道菌群分布与HTN、MHC、LHC均存在显著差异。在对肠道菌群组成成分的分析中, HTC在门水平、属水平亦显示出不同于MHC、LHC的特征, 其致病菌如链球菌(Streptococcus)、埃希氏菌_志贺氏菌(Escherichia_Shigella)和克雷伯氏菌(Klebsiella)的相对丰度下降, 有益菌如粪杆菌(Faecalibacterium)、普氏菌(Prevotella)、链型杆菌(Catenibacterium)和乳酸杆菌(Lactobacillus)的相对丰度升高。
结论高海拔藏族CHD患者肠道菌群呈现出不同于同海拔藏族健康人群以及中、低海拔CHD患者的多态性。

Abstract:
Objective To analyze the distribution and composition of intestinal flora in Tibetan patients with coronary artery heart disease (CHD) on the Qinghai-Tibet Plateau.
Methods From September 2018 to September 2020, following patients were recruited: Tibetan CHD patients living in the area of Qinghai-TibetPlateau altitude 3600-4500 m, Tibetan patients at high altitudes with CHD (HTC), healthy people (normal Tibetans at high altitudes(HTN), Han patients with CHD living in Xining altitude 2260 m, Han CHD at a middle altitude (MHC) and Wuhan altitude 13 m, Han CHD at a low altitude(LHC), for a long time. Among them, HTC and MHC were all from inpatients of the Department of Cardiology, Affiliated Hospital of Qinghai University. HTN were all from the Physical Examination Center of the Affiliated Hospital of Qinghai University, and LHC were all from inpatients of the Department of Cardiology, the Union Hospital Affiliated to Huazhong University of Science and Technology. The fecal samples were collected, and the 16S rRNA V3-V4 regions of the intestinal flora were DNA sequenced and bioinformatic analysis was performed.
Results A total of 36 CHD patients (8 HTC, 14 MHC, 14 LHC) and 34 HTN patients that met the inclusion and exclusion criteria were enrolled. α-diversity analysis showed that there was no significant difference in the Shannon index of intestinal flora between HTC and HTN (P=0.091), the Shannon index of intestinal flora in HTC was the highest, followed by MHC, and the lowest in LHC(P=0.025). β-diversity analysis showed that the intestinal flora distribution of HTC was significantly different from that of HTN, MHC and LHC. In the analysis of the composition of intestinal flora, HTC also showed different characteristics from MHC and LHC at the phylum level and genus water. The relative abundance of its pathogenic bacteria, i.e. Streptococcus, Escherichia_Shigella and Klebsiella decreased; the beneficial bacteria, i.e. Faecalibacterium, Prevotella, Catenibacterium and Lactobacillus, were increased in relative abundance.
Conclusions The intestinal flora of high-altitude Tibetan patients with CHD showed polymorphisms that were different from those of healthy Tibetans at the same altitude and CHD patients at medium and low altitudes.

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