妊娠期高血压患者肠道菌群分布及其与血清HtrA3、25(OH)D水平的关系

Distribution of gut microbiota in patients with gestational hypertension and its correlations with serum HtrA3 and 25(OH)D levels

摘要

目的 探讨妊娠期高血压患者肠道菌群分布特征及其与血清丝氨酸蛋白酶A3(HtrA3)、25羟基维生素D[25(OH)D]水平的相关性。方法 选取2021年5月至2023年5月期间在本院就诊的106例妊娠期高血压患者作为研究组,选取同期体检健康的妊娠孕妇98例作为对照组;同时收集整理其临床特征资料.采用16s rDNA测序技术检测两组肠道菌群,并比较两组肠道菌群多样性及其相对丰度;采用ELISA法检测两组血清HtrA3、25(OH)D水平;采用Pearson法分析妊娠期高血压患者肠道菌群与血清HtrA3、25(OH)D水平的相关性。结果 与对照组相比,研究组Chao1指数、Ace指数、Shannon指数明显降低,Simpson指数明显升高(Z值介于2.462~5.163之间,均P<0.05).门水平上,与对照组相比,研究组厚壁菌门、拟杆菌门、放线菌门菌群相对丰度明显降低(t值介于2.976~10.722之间),变形菌门相对丰度明显升高(t=2.569);属水平上,乳杆菌属、双歧杆菌属、毛螺菌属、Rikenellaceae属、真杆菌属相对丰度明显降低(t值介于2.344~11.277之间),肠球菌属相对丰度明显升高(t=4.220)(均P<0.05).与对照组相比,研究组血清HtrA3水平明显升高,25(OH)D水平明显降低(t=8.425、8.308,P<0.05).Pearson相关性分析结果显示,乳杆菌属、双歧杆菌属、真杆菌属、毛螺菌属、Rikenellaceae属与血清HtrA3水平呈负相关(r值介于-0.581~-0.478之间),与25(OH)D水平呈正相关(r值介于0.470~0.638之间);肠球菌属与血清HtrA3水平呈正相关(r=0.527),与25(OH)D水平呈负相关(r=-0.479)(均P<0.05)。结论 妊娠期高血压患者肠道菌群与血清HtrA3、25(OH)D之间有明显相关性,临床上检测二者相关性对治疗妊娠期高血压具有重要意义.

Abstract

Objective To investigate distribution characteristics of intestinal microbiota in patients with gestational hypertension and its correlations with serum serine protease A3 (also called high-temperature-requirement A, HtrA3) and 25 hydroxyvitamin D [25(OH)D] levels. Methods A total of 106 patients with gestational hypertension who were treated in our hospital from May 2021 to May 2023 were selected as study group, and 98 healthy pregnant women who received regular antenatal examination in the same period were as control group. The clinical characteristic data of the pregnant women in the two groups were collected and sorted simultaneously. 16s rDNA sequencing technology was applied to detect gut microbiota of the pregnant women in the two groups, and diversity and relative abundance of gut microbiota were compared between the two groups. Enzyme-linked immunosorbent assay (ELISA) was applied to detect serum HtrA3 and 25(OH)D levels of the pregnant women in the two groups. Pearson correlation analysis was applied to analyze correlations between gut microbiota and serum HtrA3 and 25(OH)D levels of the patients with gestational hypertension. Results Compared with the control group, Chao1 index, Ace index and Shannon index of the patients in the study group were significantly lower, while the Simpson index was significantly higher (Z values ranged from 2.462 to 5.163, all P<0.05). At the phylum level, compared with the control group, the relative abundances of Firmicutes, Bacteroidetes and Actinobacteria phyla in the study group were significantly lower (t=2.976-10.722, all P<0.05), while the relative abundance of Proteobacteria phylum was significantly higher (t=2.569, P<0.05). At the genus level, the relative abundances of Lactobacillus, Bifidobacterium, Spirillum, Rikenellaceae and Eubacterium genera were significantly lower (t=2.344-11.277, all P<0.05), while the abundance of Enterococcus genus was significantly higher (t=4.220, P<0.05). Compared with the control group, the serum HtrA3 level of the patients in the study group was significantly higher, while their serum 25(OH)D level was significantly lower (t=8.425 and 8.308 respectively, both P<0.05). Pearson correlation analysis showed that Lactobacillus, Bifidobacterium, Eubacterium, Spirillum and Rikenellaceae were negatively correlated with serum HtrA3 level (r=-0.492, -0.480, -0.581, -0.478 and -0.482 respectively, all P<0.01), and were positively correlated with serum 25(OH)D level (r=0.603, 0.470, 0.538, 0.638 and 0.485 respectively, all P<0.01). Enterococcus was positively correlated with serum HtrA3 level (r=0.527, P<0.001), and was negatively correlated with serum 25(OH)D level (r=-0.479, P<0.01). Conclusion There are close correlations between gut microbiota and serum HtrA3 and 25(OH)D levels in patients with gestational hypertension, which is of great significance for treatment of gestational hypertension in clinical practice.

关键词

妊娠期高血压 / 肠道菌群 / 血清丝氨酸蛋白酶A3 / 25羟基维生素D

Key words

gestational hypertension / gut microbiota / serum high-temperature-requirement A3 / 25 hydroxyvitamin D

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基金资助

保定市科技计划项目(2241ZF186)