Characteristics Of Intestinal Flora In Patients With Hashimoto’s Thyroiditis With Different Tongue Coatings

Objective:1.To explore the composition of intestinal flora and different species between Hashimoto’s thyroiditis group and control group,and further analyze thyroid function（FT₃,FT₄,TSH）,thyroid autoimmune antibodies（TGAb,TPOAb）,and age Correlation between intestinal flora.2.To explore the composition of intestinal flora and different species of different tongue coating types in patients with Hashimoto’s thyroiditis.Method:First,from August 2020 to December 2020,recruit 15 volunteers who meet the criteria of Hashimoto’s thyroiditis group and the control group at the outpatient clinic of Hubei Provincial Hospital of Traditional Chinese Medicine.At the same time,the general information（age,gender）,clinical data（thyroid function,thyroid autoimmune antibody）of the two groups were collected,and the type of tongue coating in the Hashimoto’s thyroiditis group,and the Hashimoto’s thyroiditis group（15 people）was divided into groups according to the tongue coating.There were thin fur group（9 people）,thick fur group（6people）,white fur group（12 people）and yellow fur group（3 people）.Secondly,16S r DNA high-throughput sequencing analysis was used to determine the species information of all stool samples,and the species composition between Hashimoto’s thyroiditis group and control group,thin fur group and thick fur group,white fur group and yellow fur group were compared and analyzed.And species differences.Finally,the correlation Heatmap chart is used to show the correlation between clinical index levels and high-abundance species.Result:1.There was no significant difference in gender and age between Hashimoto’s thyroiditis group and control group,thin fur group and thick fur group,white fur group and yellow fur group（P>0.05）.2.According to sequencing statistics,the number of effective sequences in the sample is 1732878,the number of effective bases is 723697438,and the average sequence length is 417.A total of 612 species（OTU）were obtained,which belonged to the following classification levels:13 phyla,21 classes,47orders,89 families,218 genera,and 400 species.In addition,the Pan/Core graph and the dilution curve indicate that the sample size of this study is reasonable.3.The Venn diagram shows that the Hashimoto’s thyroiditis group contains507 species,the control group contains 536 species;the thin fur group contains 453 species,and the thick fur group contains 352 species;the white fur group contains 475 species,The yellow fur group contains 310 species.4.After Alpha diversity analysis,the community richness of Hashimoto’s thyroiditis group was lower than that of the control group at the order and family level（P<0.05）;the community richness of the thick fur group was higher than that of the thin fur group at the class level（P<0.05）;At the family level,the uniformity of the yellow fur group is better than that of the white fur group（P<0.05）.5.Comparing the average relative abundance levels of different species between the Hashimoto’s thyroiditis group and the control group,there was no significant difference between the two groups at the phylum level（P>0.05）,and only the cyanobacteria were significant between the two groups at the class level（P<0.05）.There are 3 types of fungi between the two groups at the order level and there are significant differences（P<0.05）.There are 7 types of fungi between the two groups at the family level and there are significant differences（P<0.05）between the two groups at the genus level.There are significant differences in 10 types of bacteria and genera（P<0.05）,and there are significant differences in 16 types of bacteria between the two groups at the species level（P<0.05）.Comparing the average relative abundance levels of different species between the thin fur group and the thick fur group,at the phylum level,only the Desulfobacterota was significantly different（P<0.05）,and between the two groups at the class,order,and family level.There are only 2 types of species that are significantly different（P<0.05）.There are 5types of bacteria between the two groups at the genus level that are significantly different（P<0.05）.There are 6 types of bacteria between the two groups at the species level that are significantly different（P<0.05）.Comparing the average relative abundance levels of different species between the white fur group and the yellow fur group,there was no significant difference between the two groups at the phylum level and the class level（P>0.05）.There are significant differences between the two groups at the order level and the family level,only Vibrionales and Vibrionaceae（P<0.05）.There are significant differences in 5 types of bacteria between the two groups at the genus level（P<0.05）,and 7 types of bacteria between the two groups at the species level（P<0.05）.6.From phylum level to species level,FT₃was negatively correlated with the abundance of 7 types of species（P<0.05）,and only positively correlated with metagenome＿g＿＿Prevotella abundance（P<0.05）;FT₄was positively correlated with the abundance of 8 types of species,but the abundance of 11types of species is negatively correlated;TGAb is negatively correlated with the abundance of 10 types of species,but only positively correlated with the abundance of 2 types of species;TPOAb is only negatively correlated with the abundance of 3 types of species,and there is no positive correlation between species;Only positively correlated with the abundance of Gammaproteobacteria（P<0.05）,and no negatively related species;Age was only negatively correlated with the abundance of two types of species（P<0.05）,and no positively related species.Conclusion:1.The structure of the intestinal flora of Hashimoto’s thyroiditis group is characterized by an increase in the level of pro-inflammatory flora,while a decrease in the level of flora that maintains immune balance.In addition,thyroid function and thyroid autoimmune antibodies are related to the intestinal flora related to the regulation of vitamin D,iron and other nutritional factors,suggesting that the intestinal flora may be involved in the pathogenesis of Hashimoto’s thyroiditis to a certain extent.Therefore,it is of great significance to prevent and treat Hashimoto’s thyroiditis by improving or adjusting the structure of the intestinal flora,but it needs further research and verification in the later period.2.The composition and structure of the intestinal flora of Hashimoto’s thyroiditis patients with different tongue coating types are different,which proves that tongue coating is an important element of TCM syndrome differentiation and provides a certain scientific basis for intuitively reflecting the microscopic changes of the disease.