不同腹型肥胖程度青少年2型糖尿病患者肠道菌群变化及其与糖脂代谢和肝脏脂肪含量的关系周强徐静厦门大学附属福州第二医院内分泌科，福建福州350007［摘要］目的探讨不同腹型肥胖程度吉少年2型糖尿病患者肠道菌群变化及其与糖脂代谢和肝脏脂肪含量的关系。方法叵I顾性选取2019年12月至2020年9月厦门大学附属福州市第二医院内分泌科收治的青少年2型糖尿病患者60例为研究对象，根据其腹型肥胖程度分为A组(非腹型肥胖，，尸12)、B组(轻度腹型肥胖,〃=16)、C组(中度腹型肥胖，/:=17)和D组(重度腹型肥胖，〃=15)。比较四组肠道菌群、糖脂代谢指标和肝脏脂肪含量，并分析患者肠道菌群与糖脂代谢指标和肝脏脂肪含量的关系。结果A组、B组、C组和D组直肠真杆菌、乳酸杆菌依次升高，多行拟杆菌、双歧杆菌依次降低，空腹血糖、餐后2h血糖、糖化血红蛋白、血浆总胆®醇(TC)、三酰甘油(TG)水平(PV0.05)。A组、B组、C组和D组肝脏脂肪含量S2〜S3级患者比例依次升高，但差异无统计学意义(户>0.05)。相关分析结果显示，青少年2型糖尿病患者的直肠真杆菌、乳酸杆菌与空腹血糖、餐后2h血糖、糖化血红蛋白、血浆TC、TG水平、肝脏脂肪含量分级均呈正相关(PV0.05):多行拟杆菌、双歧杆菌与其空腹血糖、餐后2h血糖、糖化血红蛋白、血浆TC、TG水平、肝岫旨肪含量分级则均呈负相关(PV0.05)。结论腹型肥胖程度可影响吉少年2型糖尿病患者肠道菌群、糖脂代谢和肝脏脂肪含量，旦患者肠道曲群与糖脂代谢和肝脏脂肪含量均相关。［关键词］腹型肥胖程度：青少年：2型糖尿病：肠道菌群；糖脂代谢：肝脏脂肪含量［中图分类号］R589.2；R725.8［文献标识码］A［文章编号］2095-0616(2021)13-0013-04Changesinintestinalfloraanditsrelationshipwithglucolipidmetabolismandliverfatcontentinadolescenttype2diabeticpatientswithdifferentdegreesofabdominalobesityZHOUQiangXUJingDepartmentofEndocrinology,FuzhouSecondHospitalAffiliatedtoXiamenUniversity,Fujian,Fuzhou350007,China［Abstract］ObjectiveToinvestigatethechangesofintestinalfloraanditsrelationshipwithglucolipidmetabolismandliverfatcontentinadolescenttype2diabeticpatientswithdifferentdegreesofabdominalobesity.MethodsAtotalof60adolescentpatientswithtype2diabetesmellilusadmittedtotheDepartmentofEndocrinologyofFuzhouSecondHospilaiAffi1iatedtoXiamenUniversityfromDecember2019loSeplembcr2020wereretrospectivclyselectedasthestudysubjects.TheyweredividedintogroupA(non-abdominalobesity,〃=12),groupB(mildabdomina.obesity,〃=16),groupC(moderateabdominalobesity,/?=17)andgroupD［severeabdominalobesity,n=15).Theintesiina'flora,glucolipidmetabolicindicesandliverfatcontentofthefourgroupswerecompared,andtherelationshipbetweenintestinalfloraandglucolipidmetabolicindicesandliverfatcontentofthepatientswasanalyzed.ResultsThenumberofeubacteriumrectaleandlactobaci11iwereincreasedsequentially,andthenumberofbacteroidesthetaiotaomicronandbifidobacteriumbifidumweredecreasedsequentiallyingroupA,B,C,and0.Thelevelsoffastingglucose,2-hpostprandialglucose,glycosylatedhemoglobin,plasmatotalcholesterol(TC),andtriglycerides(TG)(P<0.05).TheproportionsofpatientswithliverfatlevelsofS2-S3ingroupA,B,CandDwasincreasedsequentially,butwithoutstatisticallysignificantdifferences(P>0.05).Theresultsofcorrelationanalysisshowedthatthenumberofeubacteriumrectaleandlactobacilliwerepositivelycorrelatedwiththelevelsoffastingglucose,2-hpostprandialglucose,glycosylatedhemoglobin,plasmaTCandTG,andthegradeofliverfatcontentinadolescenttype2diabeticpatients(P<0.05).However,thenumberofbacteroidesthetaiotaomicronandbifidobacteriumbifidumwerenegativelycorrelatedwiththelevelsoffastingglucose,2-hpostprandialglucose,glycosylatedhemoglobin,plasmaTCandTG,andt...