| Objective:To investigate the relative content of the ten common intestinal flora in female patients with type 2 diabetes mellitus(T2DM)and coronary heart disease(CHD)was determined by real-time fluorescent quantitative PCR detection technology.The aims were to explore the characteristics of the intestinal flora of female T2 DM patients with CHD and to analyse of related factors.Methods:Female patients with T2 DM who were hospitalized in the Endocrinology Department of our hospital from September 2019 to November 2020 were enrolled in this study and divided into two groups according to whether they had coronary heart disease: 22 patients with coronary heart disease(T2DM+CHD group);49 patients with simple T2 DM group(T2DM group).31 healthy females were selected as the healthy control group(HC group).Collect the general clinical data of the enrolled patients,check the patient’s height,weight,blood pressure and other indicators,and calculate the body mass index.Stool and blood samples of patients were collected according to standard procedures,and the Beckman AU5800 automatic biochemical analyzer was used to determine biochemical indicators;real-time fluorescent quantitative PCR detection technology was used to determine 10 types of intestinal bacteria(Clostridium leptum 、Prevotella 、 Faecalibacterium prausnitzii 、 Roseburia inulinivorans 、Enterococcus spp、Veillonellaceae、Eubacterium rectale、Bacteroides、Bifidobacterium spp.、Bifidobacterium spp.).SPSS 23.0 statistical software was used for data analysis to compare the differences of indicators between the groups and analyze the correlation between relevant biochemical indicators and intestinal flora.Results:1.Comparison of general clinical characteristics in the three groupsThe BMI and the proportion of smoking history,drinking history and hypertension history in the T2 DM group and in the T2DM+CHD group was higher than that in the HC group,respectively(P<0.05).The BMI,diabetes duration and the proportion of smoking history,drinking history and insulin application in the T2DM+CHD group was higher than that in the T2 DM group,while the proportion of metformin medication was lower than that in the T2 DM group,respectively(P<0.05).The proportion of hypertension history in the T2DM+CHD group was higher than that in the T2 DM group,but the difference was not statistically significant(P>0.05).2.Comparison of blood biochemical indicators in the three groupsThe level of Hb A1c、FBG、TCH、TG and LDH in the T2 DM group and the T2DM+CHD group was higher than that in the HC group and the level of CKMB、UREA、CRE、UA in the T2DM+CHD group was higher than in the HC group,respectively(P<0.05).The level of C-P 、 UREA in the T2DM+CHD group was higher than that in the T2 DM group,respectively(P<0.05).3.Comparison of the content of intestinal flora in the three groupsThe content of Prevotella in the T2 DM group was lower,and the content of Roseburia inulinivorans and Faecalibacterium prausnitzii in the T2DM+CHD group was lower,while the content of Bacteroides and Enterococcus spp in the T2DM+CHD group was higher than that in the HC group,respectively(P<0.05).The content of Bacteroides and Enterococcus spp in the T2DM+CHD group was lower han that in the T2 DM group,respectively(P<0.05).4.Correlation analysis between intestinal flora and related clinical indicators in the three groupsSpearman correlation analysis showed that the content of Bacteroides was negatively correlated with metformin medication.The content of Roseburia inulinivorans was positively correlated with insulin application,while the Bacteroides and Enterococcus spp was negatively correlated with it.The content of Bacteroides and Enterococcus spp was positively correlated with glycosylated hemoglobin A1 c,while the Faecalibacterium prausnitzii,Eubacterium rectale and Roseburia inulinivorans was negatively correlated with it.The content of Bacteroides and Enterococcus spp was positively correlated with fasting blood glucose,while the Roseburia inulinivorans was negatively correlated with it.The content of Prevotella was positively correlated with fasting C-peptide,while the Enterococcus spp was negatively correlated with it.The content of Bacteroides was positively correlated with TCH.The content of Bacteroides was positively correlated with TG,while the Clostridium leptum was positively with it.The content of Bifidobacterium spp.,Lactobacillus and Roseburia inulinivorans was positively correlated with it.The Prevotella and Lactobacillus was positively correlated with UREA.The content of Bacteroides was positively correlated with UA(P<0.05).5.Binary logistic regression analysis on relative factors for female type2 diabetes mellitus with coronary heart diseaseBinary logistic regression analysis showed that Bacteroides and Enterococcus spp were associated with the development of female patients with type 2 diabetes mellitus and coronary heart disease(P<0.05).Conclusion:1.Female T2 DM and T2 DM with CHD had intestinal flora imbalance,which were related to a variety of glucose and lipid metabolism indicators.This might be closely related to the occurrence of T2 DM and CHD in female.2.Bacteroides and Enterococcus spp were independent influencing factor of the development of female patients with T2 DM and CHD. |
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