妊娠期糖尿病患者肠道菌群特征与妊娠期高血压疾病的关联研究

Background??Pregnant women with gestational diabetes mellitusGDMare often comorbid with hypertensive disorders of pregnancyHDPwhich can severely impact pregnancy health and delivery outcomes. The relationship between gut microbiota and pregnancy health has received increasing attentionbut its association with concurrent HDP in GDM remains to be investigated. Objective ?To explore the association between gut microbiota characteristics and concurrent HDP in GDM patients. Methods ?The 204 patients with GDM who underwent prenatal examination at the Obstetrics and Gynecology Hospital of Hangzhou from August 2019 to January 2020 were selected as the study subjects. Pregnant women diagnosed with GDM only were categorized as the GDM groupn=181while those concurrently diagnosed with GDM and HDP were categorized as the GDM with concurrent HDP groupn=23. Clinical data and inflammation detection markers of the enrolled pregnant women were collectedand fecal samples of the same period were retained for gut microbiota 16s rDNA amplicon sequencing analysis. LEfSe analysis was used to compare microbiota composition between the two groups at the phylumfamily and genus levelsand to identify distinct bacterial enrichments. Logistic regression analysis was performed to identify gut microbiota characteristics associated with concurrent HDP in GDM. Spearman's rank correlation analysis was performed to explore the association between gut microbiota and inflammatory markers. Results ?No significant differences were found in overall gut microbiota composition and relative abundances of major phyla between the two groupsP>0.05. LEfSe analysis on family level showed that the Veillonellaceae?family was enriched in the GDM with concurrent HDP groupP<0.05while Mollicutes RF39 unclassified family?and Lachnospiraceae?were depletedP<0.05. At the genus levelDialisterIntestinibacterEubacterium and Parasutterella?were enriched in the GDM with concurrent HDP groupP<0.05whereas Eubacterium xylanophilum groupRuminiclostridium 6Mollicutes RF39 unclassified genus?and Lachnospiraceae unclassified genus?were enriched in the GDM groupP<0.05. Logistic regression analysis results showed increased abundances of VeillonellaceaeOR=1.0695%CI=1.01~1.11DialisterOR=1.2695%CI=1.10~1.45and IntestinibacterOR=2.0795%CI=1.12~3.84were independent risk factors for concurrent HDP in GDMP<0.05while increased Lachnospiraceae was a protective factorP<0.05. Spearman's rank correlation analysis results showed Veillonellaceae?was positively correlated with the proportion of monocytesrs=0.149P<0.05Dialister?was positively correlated with leukocyte counteosinophil leukocyteand eosinophil countrs=0.1510.1630.171P<0.05. Conclusion ?Increased abundances of VeillonellaceaeDialister?and Intestinibacter?are independent risk factors for concurrent HDP in GDM pregnant womenwhile increased abundance of Lachnospiraceae unclassified genus?is a protective factor. Veillonellaceae?and Dialister?are positively correlated with multiple inflammatory markers. Gut microbiota may be an important risk factor for concurrent HDP in GDM.