Correlation Between Intestinal Flora And Coronary Artery Lesions In Patients With Type 2 Diabetes Mellitus Combined With Coronary Artery Disease

Objective:Type 2 diabetes is often accompanied by the development of coronary atherosclerosis,and type 2 diabetes combined with coronary heart disease is a major cause of disability and death in type 2 diabetics.However,the effect of intestinal flora on the development of coronary atherosclerosis in type 2diabetic patients is still unclear.Therefore,this study aims to explore the relationship between intestinal flora and coronary artery disease in patients with type 2 diabetes mellitus and coronary artery disease by analysing the quantitative and structural characteristics of intestinal flora in patients with type2 diabetes mellitus and coronary artery disease compared with those in the healthy population,and to analyse the correlation between these significantly different flora and clinical biochemical parameters and coronary artery disease,so as to provide new ideas for the prevention,mechanism and treatment of type2 diabetes mellitus and coronary artery disease in the future.The study will provide new ideas for the prevention,mechanism and treatment of type 2diabetes combined with coronary artery disease.Method:Stool samples were collected from 80 patients with type 2 diabetes combined with coronary artery disease who underwent coronary angiography(CAG)at the Second Affiliated Hospital of Guilin Medical University and from healthy population,and 16 Sr RNA sequencing analysis was performed to compare the differences in intestinal flora composition between the two groups.The Gensini score was used to quantify the severity of coronary artery stenosis by comparing the differences in intestinal flora abundance and biochemical parameters between healthy controls,the low-risk group with type 2 diabetes combined with coronary artery disease(Gensini score <52)and the high-risk group with type 2 diabetes combined with coronary artery disease(Gensini score ≥52).Spearman’s correlation analysis was used to reveal the relationship between intestinal flora and clinical biochemical parameters and the severity of coronary artery stenosis in type 2 diabetic patients.Result:1.There were no significant differences in clinical baseline information such as gender,diastolic blood pressure,height,weight,BMI,and alcohol consumption rates between the three groups.Age,systolic blood pressure,smoking rate,and history of hypertension were significantly higher in the high-risk and low-risk groups than in the healthy control group(P < 0.05),but no significant differences were found between the high-risk and low-risk groups.2.The levels of WBC,LDL-C,FPG,and Hb Alc were significantly higher in the low-risk and high-risk groups compared with the healthy control group(P < 0.05),and the changes in WBC levels were more pronounced in the high-risk group(P < 0.05).3.The number of species in the intestinal flora of the three groups was not significantly different,but the abundance of species changed.4.Alpha diversity analysis: the ACE index,Chao1 index,Shannon index,Simpson index and Faith＿pd index of the intestinal flora of the three groups were not significantly different.5.There was no significant difference in the species composition of the intestinal flora of the three groups.6.Changes in the abundance of the intestinal flora of the three groups: Proteobacteria,Gammaproteobacteria,Enterobacterales,Lactobacillales,Enterobacteriaceae,Escherichia-Shigella in the intestinal flora of patients in the low-risk group and the high-risk group.Escherichia-Shigella were significantly higher than the healthy control group(P < 0.05),but there was no significant difference in the abundance of these groups between the low-risk and high-risk groups;In contrast,Oscillospirales and Faecalibacterium abundance levels were significantly lower in patients in the low-risk and high-risk groups compared to healthy controls(P < 0.05),and more significantly in the high-risk group(P <0.05).7.Correlation analysis between significantly different intestinal flora and clinical biochemical indicators: Proteobacteria phylum,Gammaproteobacteria,Enterobacteriaceae,Escherichia-Shigella and WBC levels showed a moderate positive correlation(r = 0.445,r = 0.422,r = 0.491,r = 0.418,P < 0.05);and all the above flora showed a moderate positive correlation(0.4 < r < 0.7,P < 0.05)with LDL-C,FPG,Hb Alc and other high risk factors for cardiovascular disease.While Faecalibacterium was moderately negatively correlated with WBC levels(r=-0.423,P < 0.05);Firmicutes,Clostridia,Oscillospirales and Faecalibacterium were all moderately negatively correlated with FPG and Hb Alc levels(-0.7 < r <-0.4,P < 0.05).8.Correlation analysis of significantly different intestinal flora and Gensini scores: Enterobacteriaceae showed a weak positive correlation with coronary Gensini scores(r=0.312,P< 0.05),Ruminococcaceae,Faecalibacterium and coronary Gensini score were weakly negatively correlated(r =-0.319,r =-0.319,P < 0.05).Conclusion:1.The abundance of Enterobacteriaceae was positively correlated with the severity of coronary artery lesions in patients with type 2diabetes combined with coronary artery disease,and the abundance of Oscillospirales,Ruminococcaceae,and Faecalibacterium was negatively correlated with the severity of coronary artery lesions in patients with type 2diabetes combined with coronary artery disease.The above groups may be used as biomarkers indicating the severity of coronary artery disease in type 2diabetes combined with coronary heart disease.2.Clostridium and Faecalibacterium are expected to be intestinal probiotics that offer new therapeutic ideas for the treatment of type 2 diabetes combined with coronary artery disease.