Study On The Distribution Characteristics Of Vaginal Flora In Patients With Gestational Diabetes Mellitus

Objective1.Exploring the development of vaginitis in pregnant women with gestational diabetes mellitus;2.To investigate the distribution characteristics of vaginal flora in gestational diabetic patients and reveal the correlation between blood glucose changes and the composition of vaginal flora;3.To provide a new idea for the diagnosis and treatment of gestational diabetes mellitus complicated with vaginitis.ContentsPart One: Analysis of the incidence of vaginitis in pregnant women with gestational diabetes mellitus1.The subjectsThe study population was selected from 265 women with singleton pregnancies,who attended the Department of Obstetrics and Gynecology of the Second Hospital of Lanzhou University from May 2021 to December 2022,all of whom underwent OGTT at 24-28 weeks of gestation and were divided into gestational diabetes mellitus group(n=40)and normal pregnancy group(n=225)according to the diagnostic criteria of gestational diabetes mellitus in Obstetrics and Gynecology,Ninth Edition,People’s Medical Publishing House and strict inclusion and exclusion criteria.2.MethodsWe collected the basic information of the enrolled subjects,inquired about the medical history and the presence of vaginitis symptoms,took the discharge from the upper 1/3 of the lateral vaginal vault in three copies,numbered one copy and sent it to the laboratory for vaginal discharge examination,and the remaining two copies were temporarily stored in the-80℃ refrigerator for the second part of the experiment.Referring to the diagnostic criteria of vaginitis in the Ninth Edition of the People’s Medical Publishing House,Obstetrics and Gynecology,the incidence of vaginitis in the two groups of pregnant women was counted.Part Two: Analysis of the distribution of vaginal flora in patients with gestational diabetes mellitus1.The subjectsThe study population was selected from the first part of 265 enrolled subjects,20 pregnant women with gestational diabetes mellitus and 20 pregnant women with normal pregnancy were randomly selected each.2.MethodsVaginal secretion samples were collected from enrolled subjects,the raw data were obtained by extracting the total DNA of the sample bacteria,16 S r DNA amplification,gene library construction and sequencing.Clustered as OTU at 97%similarity after filtering and optimization,compared with Silva database for species annotation,to explore the distribution characteristics of the two groups of microbial communities and compare their Alpha diversity,Beta diversity and community differences between groups.ResultsPart One: Analysis of the incidence of vaginitis in pregnant women with gestational diabetes mellitus1.Vaginal p H was slightly lower in the gestational diabetes mellitus group than in the normal pregnancy group,but the results were not statistically different(P>0.05);2.The incidence of vaginitis in the gestational diabetes mellitus group was slightly higher than that in the normal pregnancy group,and the difference was not statistically significant(P>0.05);the prevalence of BV and TV was relatively high in the gestational diabetes mellitus group,while the prevalence of VVC was relatively low.Part Two: Analysis of vaginal flora distribution in patients with gestational diabetes mellitus1.The vaginal bacterial community in the gestational diabetes mellitus group was still dominated by Lactobacillus,accounting for about 65.9%,which was slightly lower than that in the normal pregnancy group(69.8%),while Gardnerella,Prevotella and Shuttleworthia increased in relative abundance;2.lactobacillus iners as the dominant lactobacillus in both the gestational diabetes mellitus group and the normal pregnancy group;3.Vaginal flora diversity and strain richness were lower in gestational diabetes mellitus group than in the normal pregnancy group,and the differences were statistically significant(P<0.05);4.Significantly different bacteria were found in the vaginal bacterial communities of both groups,and those with a greater impact on gestational diabetes mellitus with Clostridia,Lachnospairaceae,Lachnospirales and Prevotellaceae etc.Conclusions1.Slightly higher incidence of vaginitis in gestational diabetes mellitus than in women with normal pregnancies;2.Reduced vaginal flora diversity and strain abundance in patients with gestational diabetes mellitus;3.Changes in vaginal flora in patients with gestational diabetes mellitus characterized by the decrease in the proportion of Lactobacillus,and an increasein the abundance of Gardnerella,Prevotella and Shuttleworthia;4.Clostridia,Lachnospairaceae,Lachnospirales and Prevotellaceae may provide biomarkers for predicting or diagnosing gestational diabetes mellitus.