摘  要：为进一步了解2型糖尿病合并腹泻患者肠道菌群与肝肾生化指标之间的相关性，收集了26例2型糖尿病合并腹泻患者和26例2型糖尿病患者的菌群数据和肝肾指标数据。采用单因素方差 (one-way ANOVA) 分析两者的肝肾指标的差异，采用线性回归分析肝肾指标与肠道微生物α多样性的关联，采用PERMANOVA程序分析肠道菌群β多样性结构差异，然后采用Spearman秩相关测试分析肝肾生化指标与肠道菌群的相关性。结果表明：两类人群肝肾指标中的甘油三酯（TG）、血尿素氮（BUN）具有显著性差异（P=0.006，P=0.003）；2型糖尿病合并腹泻患者的血清胆红素的升高与肠道菌群的物种多样性的降低相关；2型糖尿病合并腹泻患者的拟杆菌、毛螺菌、普雷沃氏菌的含量降低，但瘤胃菌的含量明显增高；毛螺菌和瘤胃菌含量与血清胆红素呈正相关，与TG的降低有关，与BUN的升高无关。2型糖尿病合并腹泻患者的肝肾指标与肠道菌群存在相关性，可为治疗2型糖尿病合并腹泻提供新菌群靶点。
关键词：2型糖尿病合并腹泻；2型糖尿病；肝肾生化指标；肠道菌群；微生物多样性
中图分类号：Q939.93                        文献标志码：ADOI：10.3969/j.issn.1007-7146.2021.05.010

Abstract: To further understand the relationship between gut microbiota and liver and kidney biochemical indicators in patients with type 2 diabetes with diarrhea. We collected the flora data and liver and kidney index data of 26 patients with type 2 diabetes with diarrhea and 26 patients with type 2 diabetes. One-way variance analysis was used to analyze the differences in liver and kidney indexes between the two groups; linear regression analysis was used to analyze the relationship between liver and kidney indicators and gut microbial alpha diversity; PERMANOVA was used to analyze the difference in structure of gut microbial β diversity; then Spearman rank correlation test was used to analyze the relationship between liver and kidney biochemical indexes and gut microbiota. The results showed that there were significant differences in triglyceride (TG) and blood urea nitrogen (BUN) in liver and kidney indexes between the two groups (P=0.006, P=0.003); the increase of serum bilirubin in patients with type 2 diabetes with diarrhea was related to the decrease of the species diversity of the intestinal flora; Bacteroides, Lacetospirillum, and Prevotella in type 2 diabetes patients with diarrhea decreased, whereas Rumenaceae significantly increased. In addition, Laospirillaceae and Rumenomycetes were positively correlated with serum bilirubin, which was related to the decrease of TG and has nothing to do with the increase of BUN. There is a relationship between liver and kidney indexes of patients with type 2 diabetes with diarrhea and gut microbiota, and these bacteria can provide new targets for the treatment of type 2 diabetes with diarrhea.
Key words: type 2 diabetes with diarrhea; type 2 diabetes; hepatic and renal biochemical indexes; gut microbiota; microbial diversity
（Acta Laser Biology Sinica, 2021, 30(5): 449-458）