Article(id=1240929923439850336, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240929920461886112, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202402138, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1707580800000, receivedDateStr=2024-02-11, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773790349110, onlineDateStr=2026-03-18, pubDate=1717948800000, pubDateStr=2024-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773790349110, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773790349110, creator=13701087609, updateTime=1773790349110, updator=13701087609, issue=Issue{id=1240929920461886112, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1773790348400, creator=13701087609, updateTime=1773827281389, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241084828704109275, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240929920461886112, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241084828704109276, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240929920461886112, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1921, endPage=1927, ext={EN=ArticleExt(id=1240929923741840245, articleId=1240929923439850336, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on intestinal microbial characteristics of 10-year risk of atherosclerotic cardiovascular disease in Tibetan population, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=

Objective To explore the differences of intestinal flora, metabolic pathways, and functional genes among people at ten-year risk of atherosclerotic cardiovascular disease (ASCVD) in Tibetan population. Methods Based on the follow-up survey data of the natural population cohort in Lhasa in southwest China, a total of 94 people were included in the “China Blood Lipid Management Guide 2023” for follow-up analysis. DNA was extracted from stool samples and analyzed by macro genomic sequencing. The composition of intestinal flora of people at different 10-year risks of ASCVD was compared by bioinformatics method. The metabolic pathway and functional genes were predicted by Kyoto Encyclopedia of Gene and Genome (KEGG) and MetaCye database. Linear discriminant analysis and generalized linear regression were used to screen differential bacteria and explore their relationship with related phenotypes. Results The α diversity of people at risk of ASCVD in the middle and high 10-year risk was significantly decreased (t=-8.213, P=0.032). Strains closely related to butyrate production such as Bacteroides uniforms, (LDA=4.035, P=0.001), Faecalibacterium prausnitzii (LDA=3.876, P=0.003), Bacteroides ovatus (LDA=3.648, P=0.006), Bacteroides fragilis (LDA=3.604, P=0.003), Ruminococcus bicirculans (LDA=3.188, P=0.009), and Roseburia hominis(LDA= 3.169, P=0.004) were enriched in the population with low 10-year risk of ASCVD. The pathways and functional genes related to lipopolysaccharide synthesis (LDA=2.619, P=0.004) and lipid metabolism (LDA=2.694, P=0.001) were significantly up-regulated in the middle and high 10-year ASCVD risk population. Conclusion The intestinal microflora and metabolic function of the people at 10-year risk of ASCVD are significantly changed, and the imbalance of intestinal flora may also be one of the important reasons for changing the 10-year risk of ASCVD.

, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Zhe-jun XIANG, Qing-yu DOU, Xing ZHAO, Shu-juan YANG, Pei-bin ZENG), CN=ArticleExt(id=1240929925516030973, articleId=1240929923439850336, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=藏族人群动脉粥样硬化性心血管疾病10年发病风险肠道微生物特征研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=

目的 探究藏族地区人群不同动脉粥样硬化性心血管疾病(ASCVD)10年发病风险人群的肠道菌群及其代谢通路和功能基因的差异。方法 基于西南区域自然人群队列拉萨地区的随访调查数据,参照《中国血脂管理指南2023》总共纳入94人进行后续分析。对样本粪便提取DNA后进行宏基因组测序分析,通过生物信息学方法,比较不同ASCVD10年发生风险人群的肠道菌群构成。并利用京都基因与基因组百科全书(KEGG)和MetaCye数据库预测其代谢通路和功能基因,采用线性判别分析和广义线性回归,筛选差异菌群以及探究其与相关表型的联系。结果 中高ASCVD10年发病风险人群的α多样性显著降低(t=-8.213,P=0.032)。与产丁酸盐密切相关的菌种如单形拟杆菌(Bacteroides uniformis,LDA=4.035, P=0.001)、普拉梭菌(Faecalibacterium prausnitzii,LDA=3.876, P=0.003)、卵形拟杆菌(Bacteroides ovatus,LDA=3.648,P=0.006)、脆弱拟杆菌(Bacteroides fragilis,LDA=3.604,P=0.003)、双环瘤胃球菌(Ruminococcus bicirculans,LDA=3.188,P=0.009)、人罗斯拜瑞菌(Roseburia hominis,LDA= 3.169,P=0.004)在低ASCVD10年风险人群中富集。并且涉及脂多糖合成(LDA=2.619,P=0.004)和脂质代谢(LDA=2.694,P=0.001)相关的通路和功能基因均在中高ASCVD 10年风险人群显著上调。结论 中高ASCVD10年发病风险人群的肠道微生物和代谢功能明显改变,肠道菌群失调可能也是改变人群ASCVD 10年发病风险的重要原因之一。

, correspAuthors=null, authorNote=null, correspAuthorsNote=
曾沛斌,E-mail:
杨淑娟,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Wz4Jx6P+wPjBdjZSNH9IJg==, magXml=9JhZRIscCSITq75/aDzBEg==, pdfUrl=null, pdf=NiTYiQLcnh1HZjoC5gDyuQ==, pdfFileSize=3776977, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=zDbT0nQxy/Gdmwt0yMSiuw==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=QDC0eaecJ3jiHpId7JFeew==, mapNumber=null, authorCompany=null, fund=null, authors=

向哲军(2000—),男,硕士在读,研究方向:微生物、公众健康与检验

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向哲军(2000—),男,硕士在读,研究方向:微生物、公众健康与检验

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Antiobesity and lipid-lowering effects of Bifidobacterium spp. in high fat diet-induced obese rats[J].Lipids in Health and Disease, 2011, 10: 116., articleTitle=Antiobesity and lipid-lowering effects of Bifidobacterium spp. in high fat diet-induced obese rats, refAbstract=null)], funds=[Fund(id=1240929930201067944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, awardId=2020YFC2008005, language=CN, fundingSource=国家重点研发计划(2020YFC2008005), fundOrder=null, country=null), Fund(id=1240929930335285681, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, awardId=2023YFC3604702, language=CN, fundingSource=国家重点研发计划(2023YFC3604702), fundOrder=null, country=null), Fund(id=1240929930461114810, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, awardId=2017YFC0907305, language=CN, fundingSource=国家重点研发计划(2017YFC0907305), fundOrder=null, country=null), Fund(id=1240929930532417985, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, awardId=2021YFQ0031, language=CN, fundingSource=四川省区域创新合作项目(2021YFQ0031), fundOrder=null, country=null), Fund(id=1240929930620498376, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, awardId=2021-YF05-00886-SN, language=CN, fundingSource=成都市技术创新研发项目(2021-YF05-00886-SN), fundOrder=null, country=null), Fund(id=1240929930750521807, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, awardId=2022-YF05-0640-SN, language=CN, fundingSource=成都市科技局项目(2022-YF05-0640-SN), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240929925788659728, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, xref=1., ext=[AuthorCompanyExt(id=1240929925792854033, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, companyId=1240929925788659728, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Public Health, Sichuan University/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1240929925801242642, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, companyId=1240929925788659728, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041)]), AuthorCompany(id=1240929925998374944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, xref=2., ext=[AuthorCompanyExt(id=1240929926010957858, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, companyId=1240929925998374944, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川大学华西医院国家老年疾病临床医学研究中心)])], figs=[ArticleFig(id=1240929928728867120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=EN, label=Figure 1, caption=The gut microbiome diversity index in different 10-year ASCVD risk groups, figureFileSmall=XsbK54MWQ6DGf7o3tlunzw==, figureFileBig=zDbT0nQxy/Gdmwt0yMSiuw==, tableContent=null), ArticleFig(id=1240929928825336122, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=CN, label=图1, caption=不同ASCVD10年发病人群肠道菌群多样性指数

注:图A为Simpson指数;图B为Shannon指数;图C为β-多样性的PCoA分析;图D为宿主表型或暴露对β多样性的影响;*表示P<0.05;**表示P<0.01。

, figureFileSmall=XsbK54MWQ6DGf7o3tlunzw==, figureFileBig=zDbT0nQxy/Gdmwt0yMSiuw==, tableContent=null), ArticleFig(id=1240929929089577291, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=EN, label=Figure 2, caption=The microbial composition in different 10-year ASCVD risk groups, figureFileSmall=zAgQFbJCQmUtHxaGkcQu8w==, figureFileBig=OHB127XJa3B3PILSTNT1EQ==, tableContent=null), ArticleFig(id=1240929929207017816, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=CN, label=图2, caption=不同ASCVD 10年发病人群肠道微生物组成差异

注:图A为门水平下肠道微生物差异;图B为种水平下肠道微生物差异。

, figureFileSmall=zAgQFbJCQmUtHxaGkcQu8w==, figureFileBig=OHB127XJa3B3PILSTNT1EQ==, tableContent=null), ArticleFig(id=1240929929299292513, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=EN, label=Figure 3, caption=Differential species and their associations with related phenotypes in different 10-year ASCVD groups, figureFileSmall=qEoe0TwT5A4u5ZCBNeug7Q==, figureFileBig=iTJDSpAvoUfFVbcQ4g+Elg==, tableContent=null), ArticleFig(id=1240929929391567207, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=CN, label=图3, caption=不同ASCVD10年发病人群肠道差异物种及其与相关表型的关联

注:图A为属水平差异物种;图B为种水平差异物种;图C为差异物种相关表型的关联;使用CLR对微生物组丰度数据进行变换,同时校正年龄、性别、BMI、吸烟程度、饮酒摄入、水果摄入、蔬菜摄入、体力活动、总能量摄入;对P<0.05的结果进行展示,通过关联Z分数(Z-score)*effect size,进行着色,白色为负向,“+”为正向,“-”为负向。

, figureFileSmall=qEoe0TwT5A4u5ZCBNeug7Q==, figureFileBig=iTJDSpAvoUfFVbcQ4g+Elg==, tableContent=null), ArticleFig(id=1240929929513202037, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=EN, label=Figure 4, caption=Intestinal microbial functional characteristics of gut microbiome in different 10-year ASCVD risk groups, figureFileSmall=Pk/hajAw+kF0/w/dqU3TSg==, figureFileBig=BDiflTh+iwCKZ1VVhBTIkQ==, tableContent=null), ArticleFig(id=1240929929609671036, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=CN, label=图4, caption=不同ASCVD10年发病人群肠道微生物功能特征

注:图A不同风险组的差异代谢通路;图B不同风险组的差异功能基因。

, figureFileSmall=Pk/hajAw+kF0/w/dqU3TSg==, figureFileBig=BDiflTh+iwCKZ1VVhBTIkQ==, tableContent=null), ArticleFig(id=1240929929865523589, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=EN, label=Table 1, caption=

Basic characteristics of Tibetan participants with HM-risk and low risk [n(%),MP25P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征HM-risk (n=38)Low risk(n=56)统计量P
年龄(岁)51.58±10.8446.86±8.942.2210.023
性别
25 (65.8)21 (37.5)6.1620.013
13 (34.2)35 (62.5)
最高教育程度
未正规上过学17 (44.74)22 (39.29)1.0240.475
小学17 (44.74)24 (42.86)
初中3 (7.89)9 (16.07)
高中(包括中专/技校)1 (2.63)0 (0)
大学(包括研究生)0 (0)1 ( 1.79)
BMI (kg/m2)26.66±4.3225.40±3.621.4820.129
腰臀比0.94 (0.89, 0.97)0.91 (0.85, 0.94)7.6160.006
舒张压 (mm Hg)84.71±11.4673.80±8.495.009<0.001
收缩压 (mm Hg)128.42±16.99109.95±12.675.708<0.001
总胆固醇 (mmol/L)4.52±1.523.93±1.082.0680.031
低密度脂蛋白 (mmol/L)2.87 (2.05, 3.60)2.21 (1.86, 2.73)5.1100.018
高密度脂蛋白 (mmol/L)1.06±0.361.06±0.360.0130.991
甘油三酯 (mmol/L)1.21 (0.89, 1.42)0.88 (0.62, 1.26)6.0490.031
空腹血糖 (mmol/L)5.06±1.494.73±0.481.3450.132
糖化血红蛋白 (%)5.80 (5.43, 6.00)5.60 (5.30, 6.00)0.8940.621
薯类摄入 (g/w)350.00 (200.00, 700.00)350.00 (200.00, 700.00)0.0960.757
红肉及其制品 (g/w)350.00 (350.00, 700.00)350.00 (93.75, 700.00)0.0030.959
家禽及其制品 (g/w)11.67 (0, 50.00)50.00 (0, 200.00)6.0230.014
蛋类及其制品 (g/w)60.00 (1.00, 243.00)100.00 (45.00, 202.50)0.4550.523
新鲜蔬菜 (g/w)700.00 (350.00, 1 400.00)700.00 (700.00, 2 100.00)3.6330.057
新鲜水果 (g/w)525.00 (100.00, 1 162.50)530.00 (237.50, 1 400.00)1.0750.356
乳类及其制品 (g/w)150.00 (20.42, 500.00)245.00 (0, 700.00)0.1960.658
大米摄入 (g/w)1 400.00 (1 050.00, 2 240.00)1 450.00 (1 120.00, 2 800.00)0.5390.463
面食摄入 (g/w)610.00 (150.00, 1 050.00)600.00 (300.00, 1 050.00)0.0060.938
杂粮摄入 (g/w)655.67 (359.58, 812.00)672.33 (405.62, 1 009.00)0.3300.566
饮茶摄入 (g/w)28.00 (9.50, 55.65)28.00 (14.00, 42.00)0.0010.981
吸烟程度
从不吸烟28 (73.68)48 (85.71)2.9240.232
过去吸过烟7 (18.42)7 (12.50)
吸烟3 ( 7.89)1 ( 1.79)
饮酒量 (g/w)1.44±2.567.11±42.17-1.0030.411
总能量摄入 (J)11 955.23±4 855.9112 688.93±4 536.39-0.7380.456
体力活动 (Mets)14.99 (9.30, 22.41)10.94 (6.57, 18.45)1.0180.925
粪便排便频次
每天多于一次1 ( 2.63)8 (14.29)6.2480.101
基本上每天一次27 (71.05)27 (48.21)
基本上隔天一次7 (18.42)16 (28.57)
每周少于三次3 ( 7.89)5 ( 8.93)
), ArticleFig(id=1240929930037490068, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240929923439850336, language=CN, label=表1, caption=

藏族中高ASCVD10年发病风险人群和低ASCVD10年发病风险人群基本特征[n(%),MP25P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征HM-risk (n=38)Low risk(n=56)统计量P
年龄(岁)51.58±10.8446.86±8.942.2210.023
性别
25 (65.8)21 (37.5)6.1620.013
13 (34.2)35 (62.5)
最高教育程度
未正规上过学17 (44.74)22 (39.29)1.0240.475
小学17 (44.74)24 (42.86)
初中3 (7.89)9 (16.07)
高中(包括中专/技校)1 (2.63)0 (0)
大学(包括研究生)0 (0)1 ( 1.79)
BMI (kg/m2)26.66±4.3225.40±3.621.4820.129
腰臀比0.94 (0.89, 0.97)0.91 (0.85, 0.94)7.6160.006
舒张压 (mm Hg)84.71±11.4673.80±8.495.009<0.001
收缩压 (mm Hg)128.42±16.99109.95±12.675.708<0.001
总胆固醇 (mmol/L)4.52±1.523.93±1.082.0680.031
低密度脂蛋白 (mmol/L)2.87 (2.05, 3.60)2.21 (1.86, 2.73)5.1100.018
高密度脂蛋白 (mmol/L)1.06±0.361.06±0.360.0130.991
甘油三酯 (mmol/L)1.21 (0.89, 1.42)0.88 (0.62, 1.26)6.0490.031
空腹血糖 (mmol/L)5.06±1.494.73±0.481.3450.132
糖化血红蛋白 (%)5.80 (5.43, 6.00)5.60 (5.30, 6.00)0.8940.621
薯类摄入 (g/w)350.00 (200.00, 700.00)350.00 (200.00, 700.00)0.0960.757
红肉及其制品 (g/w)350.00 (350.00, 700.00)350.00 (93.75, 700.00)0.0030.959
家禽及其制品 (g/w)11.67 (0, 50.00)50.00 (0, 200.00)6.0230.014
蛋类及其制品 (g/w)60.00 (1.00, 243.00)100.00 (45.00, 202.50)0.4550.523
新鲜蔬菜 (g/w)700.00 (350.00, 1 400.00)700.00 (700.00, 2 100.00)3.6330.057
新鲜水果 (g/w)525.00 (100.00, 1 162.50)530.00 (237.50, 1 400.00)1.0750.356
乳类及其制品 (g/w)150.00 (20.42, 500.00)245.00 (0, 700.00)0.1960.658
大米摄入 (g/w)1 400.00 (1 050.00, 2 240.00)1 450.00 (1 120.00, 2 800.00)0.5390.463
面食摄入 (g/w)610.00 (150.00, 1 050.00)600.00 (300.00, 1 050.00)0.0060.938
杂粮摄入 (g/w)655.67 (359.58, 812.00)672.33 (405.62, 1 009.00)0.3300.566
饮茶摄入 (g/w)28.00 (9.50, 55.65)28.00 (14.00, 42.00)0.0010.981
吸烟程度
从不吸烟28 (73.68)48 (85.71)2.9240.232
过去吸过烟7 (18.42)7 (12.50)
吸烟3 ( 7.89)1 ( 1.79)
饮酒量 (g/w)1.44±2.567.11±42.17-1.0030.411
总能量摄入 (J)11 955.23±4 855.9112 688.93±4 536.39-0.7380.456
体力活动 (Mets)14.99 (9.30, 22.41)10.94 (6.57, 18.45)1.0180.925
粪便排便频次
每天多于一次1 ( 2.63)8 (14.29)6.2480.101
基本上每天一次27 (71.05)27 (48.21)
基本上隔天一次7 (18.42)16 (28.57)
每周少于三次3 ( 7.89)5 ( 8.93)
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藏族人群动脉粥样硬化性心血管疾病10年发病风险肠道微生物特征研究
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向哲军 1 , 窦青瑜 2 , 赵星 1 , 杨淑娟 1 , 曾沛斌 1
现代预防医学 | 流行病与统计方法 2024,51(11): 1921-1927
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现代预防医学 | 流行病与统计方法 2024, 51(11): 1921-1927
藏族人群动脉粥样硬化性心血管疾病10年发病风险肠道微生物特征研究
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向哲军1, 窦青瑜2, 赵星1, 杨淑娟1 , 曾沛斌1
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041
  • 2.四川大学华西医院国家老年疾病临床医学研究中心
  • 向哲军(2000—),男,硕士在读,研究方向:微生物、公众健康与检验

通讯作者:

曾沛斌,E-mail:
杨淑娟,E-mail:
Study on intestinal microbial characteristics of 10-year risk of atherosclerotic cardiovascular disease in Tibetan population
Zhe-jun XIANG1, Qing-yu DOU2, Xing ZHAO1, Shu-juan YANG1 , Pei-bin ZENG1
Affiliations
  • West China School of Public Health, Sichuan University/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2024-06-10 doi: 10.20043/j.cnki.MPM.202402138
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目的 探究藏族地区人群不同动脉粥样硬化性心血管疾病(ASCVD)10年发病风险人群的肠道菌群及其代谢通路和功能基因的差异。方法 基于西南区域自然人群队列拉萨地区的随访调查数据,参照《中国血脂管理指南2023》总共纳入94人进行后续分析。对样本粪便提取DNA后进行宏基因组测序分析,通过生物信息学方法,比较不同ASCVD10年发生风险人群的肠道菌群构成。并利用京都基因与基因组百科全书(KEGG)和MetaCye数据库预测其代谢通路和功能基因,采用线性判别分析和广义线性回归,筛选差异菌群以及探究其与相关表型的联系。结果 中高ASCVD10年发病风险人群的α多样性显著降低(t=-8.213,P=0.032)。与产丁酸盐密切相关的菌种如单形拟杆菌(Bacteroides uniformis,LDA=4.035, P=0.001)、普拉梭菌(Faecalibacterium prausnitzii,LDA=3.876, P=0.003)、卵形拟杆菌(Bacteroides ovatus,LDA=3.648,P=0.006)、脆弱拟杆菌(Bacteroides fragilis,LDA=3.604,P=0.003)、双环瘤胃球菌(Ruminococcus bicirculans,LDA=3.188,P=0.009)、人罗斯拜瑞菌(Roseburia hominis,LDA= 3.169,P=0.004)在低ASCVD10年风险人群中富集。并且涉及脂多糖合成(LDA=2.619,P=0.004)和脂质代谢(LDA=2.694,P=0.001)相关的通路和功能基因均在中高ASCVD 10年风险人群显著上调。结论 中高ASCVD10年发病风险人群的肠道微生物和代谢功能明显改变,肠道菌群失调可能也是改变人群ASCVD 10年发病风险的重要原因之一。

ASCVD10年发病风险  /  肠道菌群  /  宏基因组学

Objective To explore the differences of intestinal flora, metabolic pathways, and functional genes among people at ten-year risk of atherosclerotic cardiovascular disease (ASCVD) in Tibetan population. Methods Based on the follow-up survey data of the natural population cohort in Lhasa in southwest China, a total of 94 people were included in the “China Blood Lipid Management Guide 2023” for follow-up analysis. DNA was extracted from stool samples and analyzed by macro genomic sequencing. The composition of intestinal flora of people at different 10-year risks of ASCVD was compared by bioinformatics method. The metabolic pathway and functional genes were predicted by Kyoto Encyclopedia of Gene and Genome (KEGG) and MetaCye database. Linear discriminant analysis and generalized linear regression were used to screen differential bacteria and explore their relationship with related phenotypes. Results The α diversity of people at risk of ASCVD in the middle and high 10-year risk was significantly decreased (t=-8.213, P=0.032). Strains closely related to butyrate production such as Bacteroides uniforms, (LDA=4.035, P=0.001), Faecalibacterium prausnitzii (LDA=3.876, P=0.003), Bacteroides ovatus (LDA=3.648, P=0.006), Bacteroides fragilis (LDA=3.604, P=0.003), Ruminococcus bicirculans (LDA=3.188, P=0.009), and Roseburia hominis(LDA= 3.169, P=0.004) were enriched in the population with low 10-year risk of ASCVD. The pathways and functional genes related to lipopolysaccharide synthesis (LDA=2.619, P=0.004) and lipid metabolism (LDA=2.694, P=0.001) were significantly up-regulated in the middle and high 10-year ASCVD risk population. Conclusion The intestinal microflora and metabolic function of the people at 10-year risk of ASCVD are significantly changed, and the imbalance of intestinal flora may also be one of the important reasons for changing the 10-year risk of ASCVD.

Ten-year risk of ASCVD  /  Intestinal flora  /  Macro genomics
向哲军, 窦青瑜, 赵星, 杨淑娟, 曾沛斌. 藏族人群动脉粥样硬化性心血管疾病10年发病风险肠道微生物特征研究. 现代预防医学, 2024 , 51 (11) : 1921 -1927 . DOI: 10.20043/j.cnki.MPM.202402138
Zhe-jun XIANG, Qing-yu DOU, Xing ZHAO, Shu-juan YANG, Pei-bin ZENG. Study on intestinal microbial characteristics of 10-year risk of atherosclerotic cardiovascular disease in Tibetan population[J]. Modern Preventive Medicine, 2024 , 51 (11) : 1921 -1927 . DOI: 10.20043/j.cnki.MPM.202402138
动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD),如缺血性心脏病、急性心肌梗死和缺血性中风等,已成为世界范围内发病率和死亡率的主要原因[1]。ASCVD 10年发病风险评估,旨在评估未来动脉粥样硬化性心血管事件及其相关危险因素的绝对风险,已成为ASCVD发生的一个公认的早期指标,以更好地预防心血管疾病(CVD)[2]。近年来肠道微生物在心血管疾病的作用受到广泛关注,ASCVD患者的肠道生态失调通常表现为微生物α多样性和厚壁菌门(Firmicutes)/拟杆菌门(Bacteroidetes)比例的降低,以及产丁酸细菌罗氏菌属(Roseburia)和真杆菌属(Eubacterium)的丰度降低[3-4],但是关于ASCVD的早期指标与肠道菌群的关系及其在藏族人群中的研究却尚不清楚。为进一步探究少数民族人群肠道菌群与ASCVD 10年发病风险的关系,本研究评估藏族人群ASCVD 10年发病风险,并采用宏基因测序技术旨在对不同发病风险人群的肠道菌群结构,代谢通路以及功能基因进行探究,为临床ASCVD的预防和治疗提供新见解。
中国西南地区自然人群研究(Chinese multi-ethnic cohort, CMEC)于2017年启动,于2019年9月结束,共招募了99 556名参与者。其随访研究阶段始于2020年7月,约有10%的基线参与者参加。本研究收集了2020年7—12月来自拉萨的111名藏族参与者的粪便样本[5]。收集其社会人口学、疾病史、个体测量等,参照《中国血脂管理指南2023》中ASCVD一级预防指标进行排除和判断,最终共纳入94名参与者,并将其划分为中高ASCVD 10年发病风险组(38人)和低ASCVD 10年发病风险组(56人)[6]。本研究经四川大学医学伦理委员会批准(K2020022),所有参与者均签署了知情同意书。
所有参与者的粪便于2020年7—12月检查当日在现场采集,结束时间为2020年12月,于2021年6月将所采集样本进行了测序。参与者的新鲜粪便收集到无菌聚丙烯标本杯中。所有样本在4℃下运输,在-80℃下保存,直到提取DNA。
宏基因组测序由Novogene Bioinformatics Technology(中国),使用Illumina NovaSeq6000平台进行处理。通过Kneaddata调用Trimmomatic (v.0.39)去除接头和低质量读数,通过Bowtie2 (v.2.4.5)去除人类基因组参考基因(GRCh38/hg38)。使用Kraken2 (v.2.1.2)鉴定宏基因组的分类组成,并在每个水平(门、目、科、属、种)上进行量化。使用HUMAnN3 (v.3.0.1)基于Kyoto Encyclopedia of Genes and Genomes (KEGG) Orthology(KO)数据库识别功能同源,并基于MetaCyc代谢途径数据库注释微生物途径。
所有的数据均采用R软件(v4.02)进行处理。使用R的vegan包(v.2.6.4)计算Shannon指数和辛普森多样性指数(Simpsons index)来衡量微生物群落的α多样性。微生物组的β多样性差异基于Bray-Curtis距离采用主坐标分析(principal cCoordinate Analysis, PCoA)进行可视化,置换多元方差分析(permutational multivariate analysis of variance,PERMANOVA)对组间差异显著性差异进行分析。通过线性判别分析(linear discriminant analysis effect size,LEfSe)分析组间差异菌。采用线性回归(linear regression)来探究差异菌和人体相关表型的关联,于微生物组数据,以种水平相对丰度的几何平均值为分母,利用中心对数变换(centered Log-Ratio transformation, CLR)归一化微生物组数据的偏态分布。同时校正年龄、性别、BMI、吸烟、饮酒摄入、水果摄入、蔬菜摄入、肉类摄入、体力活动、总能量摄入,检验水准α=0.05。
表1所示,本研究共纳入94名藏族参与者,其中中高风险组(HM-risk group)38人,低风险组(low risk group)56人。两组组间年龄、性别、腰臀比、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-CH)、甘油三酯(TG)存在统计学差异(P<0.05)。中高风险组的年龄和腰臀比均显著高于低风险组。中高风险组的TG、TC、和LDL-CH显著高于低风险组,但高密度脂蛋白(HDL-CH)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)的差异在两组间没有统计学意义。
α多样性表示了物种的含量、丰富度和均匀度。 Shannon指数能够反应群落的物种数量和均匀度,因此Shannon指数越大,代表物种多样性越高。 Simpsons兼顾了群落物种的丰富度和均匀度,Simpsons指数越大,同样也代表物种的多样性越高。在本研究中,中高风险人群中,其Shannon指数和Simpsons指数,明显低于低风险人群,但只有Shannon指数的差异具有显著性(t=-8.213,P=0.032),见图1A、B。β多样性可以比较不同组别的群落的差异和相似性。本研究采用基于Bray-Curtis距离的PCoA分析,见图1C,PERMANOVA结果表明,不同风险人群组肠道微生物群落之间具有显著性差异,并且对群落总变异的贡献约为2% (R2=0.021,P=0.036)。并且我们发现宿主的个体表型对肠道微生物变异具有较大的解释程度,其中排名前三位的分别是吸烟程度、BMI、性别,见图1DP<0.005)。
在门水平上,丰度排名前5的门中,中高风险人群的拟杆菌门(Bacteroidetes,H=5.414,P=0.019)的相对丰度显著低于低风险人群,而线虫动物门(Nematoda,H=7.736,P=0.005)、扁形动物门(Platyhelminthes,H=9.593,P=0.001)、子囊菌门(Ascomycota,H=6.582,P=0.101)的相对丰度较低风险人群较高,见图2A。在种水平上,丰度排名前10的菌种中,普通拟杆菌(Phocaeicola vulgatusH=4.654,P= 0.031)、卵形拟杆菌(Bacteroides ovatusH=11.388,P=0.001)、单形拟杆菌(Bacteroides uniformisH=7.522,P=0.006)的相对丰度在低风险人群中较高,见图2B
为了进一步研究不同风险人群的肠道菌群差异物种,我们将非细菌界的微生物进行了排除,最终得到了487菌种。通过LEfSe分析,我们发现在属水平鉴定出17个属在不同风险人群中存在差异,与中高风险人群相比,只有拟杆菌属(Bacteroides,LDA=4.476, P= 0.003)在低风险人群中富集,见图3A。而其他如梭菌属(Clostridium,LDA=3.348,P=0.005)、韦荣球菌属(Veillonell,LDA=2.817)、嗜血杆菌(Haemophilus,LDA=2.564)、沙尔菌属(Schaalia,LDA=2.438)等则都在中高风险人群中富集。而在种水平上,发现55个菌种存在差异,按照LDA排名前30的种进行展示,单形拟杆菌(Bacteroides uniformis,LDA=4.035, P=0.001)、普拉梭菌(Faecalibacterium prausnitzii,LDA=3.876, P=0.003)、卵形拟杆菌(Bacteroides ovatus,LDA=3.648,P=0.006)、脆弱拟杆菌(Bacteroides fragilis,LDA=3.604,P=0.003)、双环瘤胃球菌(Ruminococcus bicirculans,LDA=3.188,P=0.009)、人罗斯拜瑞菌(Roseburia hominis,LDA=3.169,P=0.004)在低风险人群中明显富集,而青春双歧杆菌(Bifidobacterium adolescentis,LDA=2.621,P=0.023)、活泼瘤胃球菌(Ruminococcus gnavus,LDA=2.589,P=0.004)、瘤胃联合乳杆菌(Ligilactobacillus ruminis,LDA=2.430,P=0.002)等菌在中高风险组明显富集,见图3B
此外,我们还研究这些了差异物种与ASCVD 10年发病风险相关表型的关联特征,通过线性回归我们发现,产气荚膜梭菌(Clostridium perfringens)、艰难梭菌(Clostridioides difficile)与甘油三酯、收缩压和舒张压呈正向关联;短型比菲德菌(Bifidobacterium Breve)、链状双歧杆菌(Bifidobacterium catenulatum)和低密度脂蛋白呈现显著负向关联。见图3
分析KEGG及KO提示中高风险组中显著富集的代谢途径包括:细菌群体感应(LDA=4.415,P=0.015)、脂多糖合成(LDA=2.619,P=0.004)、脂质和动脉粥样硬化(LDA=2.694,P=0.001)、ABC转运器(LDA=2.620,P= 0.005),见图4A。而涉及与脂质和动脉粥样硬化的相关KO基因,在中高风险组也明显高于低风险组,且差异具有统计学意义(t=-4.368,P=0.039),见图4B
肠道微生物在脂质代谢、能量吸收等方面起到重要作用。肠道微生物也参与了多种非传染性疾病的发生发展,如2型糖尿病[7]、非酒精性脂肪肝病[8]、血脂异常等[9]。本研究针对藏族自然人群,采用宏基因组测序技术,对其ASCVD10年发病风险与肠道菌群的组成、功能以及代谢特征进行了分析。
本研究发现相比低风险组,中高风险组的α多样性降低,这与Jie等[3]的研究类似。反映了中高风险人群的微生物多样性呈现一定的下降趋势。本研究的β多样性在两组间具有显著差异,这与Li等[10]的研究相类似,但其研究结果表明,第一主成分PCA1(principal component analysis 1)的贡献最大,高达25.6%,提示不同ASCVD风险人群,其微生物组间呈现较大差异,这和我们结果存在一定差别,可能的原因是因为Li等的研究为英国女性人群,和我国的西南人群在种族和饮食习惯呈现明显区别,这点也在Fu等[11-12]的研究表现明了这些因素对菌群的构成和功能上起到一定影响。中高风险组中,拟杆菌等相对丰度降低,该门下产生短链脂肪酸(short-chain fatty acid, SCFAs)的物种,普通拟杆菌,卵形拟杆菌,单形拟杆菌等显著降低[13]。SCFAs在维持肠道黏膜屏障的完整性和通透性中发挥重要作用[14]。本研究发现上述与肠道屏障相关的菌种的相对丰度下降,提示肠道屏障功能破坏可能与人群的ASCVD 10年发病风险的升高有关,提示补充有助于肠道屏障修复相关的益生菌可能有益于降低ASCVD发病风险。
本研究显示拟杆菌在中高风险组中显著下降,差异物种的进一步分析发现,中高风险组中产SCFAs的物种单形拟杆菌、普拉梭菌、卵形拟杆菌、脆弱拟杆菌、双环瘤胃球菌、人罗斯拜瑞菌的相对丰度显著降低。既往研究表明普拉梭菌可能在降低血脂方面发挥作用[15],这可能是由于该菌具有多种碳水化合物活性酶(CAZyme),使它们能够将食物摄入中的果胶发酵成SCFAs[16]。并且先前的研究也发现普拉梭菌的丰度与丁酸盐产量呈正相关[17]。丁酸盐可以减少巨噬细胞中活性氧(ROS)、一氧化氮和炎症介质的产生,下调TLR3和TLR4,并使TLR-NFκB和HDAC轴失活[18],最终降低ASCVD发生的可能性。而通过LEfSe分析发现活泼瘤胃球在中风险人群中显著升高。最近的一项研究表明,活泼瘤胃球产生一种具有鼠李糖主干和葡萄糖侧链的复杂葡萄糖[19],通过Toll样受体4 (toll-like receptor, TLR4)诱导树突状细胞产生肿瘤坏死因子α (tumor necrosis factor-alpha, TNF-α),从而促进炎症[20]。TNF-α是一种有效的多效细胞因子,在动脉粥样硬化的发展过程中发挥炎症作用[21]。然而,关于活泼瘤胃球的功能报道仍然存在争议,因为它与饮食中的甘油三酯和肥胖呈正相关[22],同时也与潜在的健康益处有关[23]
宏基因组技术区别于16s RNA测序技术,能够进一步探讨肠道菌群的基因功能等信息。功能分析发现,在中高风险组中脂多糖合成以及脂质和动脉粥样硬化功能等通路的明显富集。之前的研究表明,脂多与ASCVD进程有着显著关联,可能会影响ASCVD的发生进展[24]。脂多糖是革兰阴性细菌的细胞壁成分[25],相关研究表明脂多糖升高的个体发生动脉粥样硬化的风险增加了三倍[26]。LPS能够激活TLR4及其下游通路介导肠上皮细胞的炎症作用,并且TLR4的缺失已被证明可以缓解动脉粥样硬化的进展[27]。这可能解释了中高风险组中LPS合成功能升高的原因。此外根据既往研究,肠道微生物群已被证明会影响小鼠和人类血液及组织中的脂质代谢和脂质水平,如An等[28]的研究发现在喂食高脂肪饮食的肥胖大鼠中,双歧杆菌属降低了循环甘油三酯和低密度脂蛋白的水平,并增加了高密度脂蛋白的水平。说明了肠道菌群在影响心血管疾病的复杂作用,但其背后的作用机制仍需要进一步研究。
本研究对藏族地区少数民族的ASCVD 10年发病风险及其宏基因组肠道菌群进行了研究。我们的研究发现中高风险人群的肠道微生物多样性下降,某些产丁酸的细菌丰度下降,并且涉及脂多糖合成和脂质代谢相关的通路和基因均有所改变。本研究为心脑血管疾病尤其是ASCVD的预防提供了潜在的干预措施。
  • 国家重点研发计划(2020YFC2008005)
  • 国家重点研发计划(2023YFC3604702)
  • 国家重点研发计划(2017YFC0907305)
  • 四川省区域创新合作项目(2021YFQ0031)
  • 成都市技术创新研发项目(2021-YF05-00886-SN)
  • 成都市科技局项目(2022-YF05-0640-SN)
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2024年第51卷第11期
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doi: 10.20043/j.cnki.MPM.202402138
  • 接收时间:2024-02-11
  • 首发时间:2026-03-18
  • 出版时间:2024-06-10
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  • 收稿日期:2024-02-11
基金
国家重点研发计划(2020YFC2008005)
国家重点研发计划(2023YFC3604702)
国家重点研发计划(2017YFC0907305)
四川省区域创新合作项目(2021YFQ0031)
成都市技术创新研发项目(2021-YF05-00886-SN)
成都市科技局项目(2022-YF05-0640-SN)
作者信息
    1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041
    2.四川大学华西医院国家老年疾病临床医学研究中心

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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