Article(id=1240950905248469809, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202311470, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1700841600000, receivedDateStr=2023-11-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773795351564, onlineDateStr=2026-03-18, pubDate=1712678400000, pubDateStr=2024-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773795351564, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773795351564, creator=13701087609, updateTime=1773795351564, updator=13701087609, issue=Issue{id=1240950898113966774, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773795349862, creator=13701087609, updateTime=1773795519367, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240951609136567133, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240951609136567134, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240950898113966774, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1222, endPage=1228, ext={EN=ArticleExt(id=1240950905533682490, articleId=1240950905248469809, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association of vegetable and fruit intake with gut microbiota during the first trimester of pregnancy, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the relationship between the intake of vegetables and fruits and the composition and diversity ofgut microbiota during the first trimester of pregnancy in Chengdu.

Methods

In total 104 early pregnant women in Chengdu were enrolled in this study. Dietary frequency questionnaire was used to collect the intake of vegetables and fruits. According to the median intake of vegetables and fruits, the early pregnant women were divided into high intake group and low intake group. The intestinal microflora of fecal samples of early pregnant women was detected by 16S rRNA highthroughput sequencing, and the differences of intestinal microflora between groups were compared. Multiple linear regression was used to explore the relationship between vegetable and fruit intake and intestinal flora in early pregnant women.

Results

The median intake of vegetables and fruits in early pregnant women was 90.0 g/d and 200.0 g/d, respectively. There was no significant difference in intestinal microflora α and β diversity between high and low intake of vegetables and fruits in early pregnancy. LEfSe analysis showed that the relative abundance of multiple intestinal microflorae in early pregnant women was significantly different between the groups with high and low intake of vegetables and fruits. Multiple linear regression analysis showed that after adjusting age, pre-pregnancy body mass index, and energy intake, early pregnant women’s vegetable intake was directly proportional to the relative abundance of Eubacterium siraeum group (β=0.007, P=0.012), inversely proportional to the relative abundance of Bacteroides (β=-0.167, P=0.023), and fruit intake was proportional to the relative abundance of Ruminococcus gnavus group (β=0.004, P=0.034), inversely proportional to the relative abundance of Agathobacter (β=0.004, P=0.044).

Conclusion

The intake of vegetables and fruits in early pregnancy leads to the change of relative abundance of intestinal flora. This study provides a new scientific basis for dietary regulation of gut microbiota during pregnancy.

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目的

探讨成都市孕早期妇女蔬菜和水果摄入与肠道菌群组成及多样性之间的关系。

方法

本研究纳入104例成都市孕早期妇女,使用膳食频率问卷收集其蔬菜和水果摄入情况,并分别依据蔬菜、水果摄入量中位数将孕早期妇女分为摄入量高组和摄入量低组。使用16S rRNA高通量测序检测孕早期妇女粪便样本肠道菌群,比较组间肠道菌群差异。采用多重线性回归探讨蔬菜、水果摄入和孕早期妇女肠道菌群的关系。

结果

孕早期妇女蔬菜和水果摄入量中位数分别是90.0 g/d和200.0 g/d。孕早期蔬菜、水果摄入高低组孕早期妇女肠道菌群α多样性和β多样性无统计学差异。LEfSe分析显示,孕早期妇女多个肠道菌群的相对丰度在蔬菜、水果摄入量高低组间存在显著差异(P<0.01)。多重线性回归分析显示,在调整了年龄、孕前体质指数和能量摄入后,孕早期妇女蔬菜摄入量与Eubacterium siraeum group相对丰度呈正比(β=0.007, P=0.012),与Bacteroides相对丰度呈反比(β=-0.167, P=0.023);水果摄入量与Ruminococcus gnavus group相对丰度呈正比(β=0.004, P=0.034),与Agathobacter相对丰度呈反比(β=0.004, P=0.044)。

结论

孕早期蔬菜、水果摄入引起肠道菌群相对丰度的变化,本研究为孕期膳食调控肠道菌群提供新的科学依据。

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成果,E-mail:
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张可馨(1998—),女,硕士在读,研究方向:流行病与卫生统计学

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Nature Reviews Gastroenterology & Hepatology, 2021, 18(2): 101-116., articleTitle=Dietary fibre in gastrointestinal health and disease, refAbstract=null)], funds=[Fund(id=1240972176506023940, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, awardId=2020YFC2006300, language=CN, fundingSource=国家重点研发计划项目(2020YFC2006300), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240972166561329616, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, xref=1., ext=[AuthorCompanyExt(id=1240972166565523921, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, companyId=1240972166561329616, 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, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1240972166573912531, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, companyId=1240972166561329616, 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=1240972166737490404, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, xref=2., ext=[AuthorCompanyExt(id=1240972166745879014, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, companyId=1240972166737490404, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.四川大学华西第二医院西部妇幼医学研究院妇儿营养中心,四川 成都 610041)]), AuthorCompany(id=1240972166846542319, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, xref=3., ext=[AuthorCompanyExt(id=1240972166854930928, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, companyId=1240972166846542319, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.四川大学华西护理学院,四川 成都 610041)])], figs=[ArticleFig(id=1240972173733589944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=EN, label=Figure 1, caption=PCoA plots based on Bray-Curtis distance for groups according to low and high intakes of vegetable and fruit in the first trimester of pregnancy (n=104), figureFileSmall=lCpFKsxUh2J08eGzf3C+sw==, figureFileBig=3vIDQU3jo6+2dPUc3R698g==, tableContent=null), ArticleFig(id=1240972173859419072, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=CN, label=图1, caption=孕早期蔬菜水果不同摄入量组肠道菌群β多样性PCoA分析(n=104)

注:根据蔬菜、水果摄入量中位数,将研究对象分为摄入量低组和摄入量高组;图A为蔬菜摄入量高低组间比较;图B为水果摄入量高低组间比较。

, figureFileSmall=lCpFKsxUh2J08eGzf3C+sw==, figureFileBig=3vIDQU3jo6+2dPUc3R698g==, tableContent=null), ArticleFig(id=1240972175377757132, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=EN, label=Figure 2, caption=LEfSe analysis to identify enriched bacteria according to low and high intakes of vegetable and fruit in the first trimester of pregnancy (n=104), figureFileSmall=BHWRGgGr9UU5oENvh/L4Xg==, figureFileBig=mKYLr2jtoOnIH/ReXI9cvQ==, tableContent=null), ArticleFig(id=1240972175491003345, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=CN, label=图2, caption=孕早期蔬菜水果摄入量肠道菌群物种差异的LEfSe分析(n=104)

注:根据蔬菜、水果摄入量中位数,将研究对象分为摄入量低组和摄入量高组;图A为蔬菜摄入量高低组间比较;图B为水果摄入量高低组间比较。

, figureFileSmall=BHWRGgGr9UU5oENvh/L4Xg==, figureFileBig=mKYLr2jtoOnIH/ReXI9cvQ==, tableContent=null), ArticleFig(id=1240972175608443864, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=EN, label=Table 1, caption=

Basic characteristics of the study participants stratified by vegetable and fruit intake (n=104)

, figureFileSmall=null, figureFileBig=null, tableContent=
特征蔬菜摄入量bχ2/ZP水果摄入量bχ2/ZP
低 (n=52)高 (n=52)低 (n=52)高 (n=52)
年龄(岁)2.8690.2381.0460.593
<3011 (21.15)9 (17.31)8 (15.38)12 (23.08)
30~3427 (51.92)35 (67.31)32 (61.54)30 (57.69)
≥3514 (26.92)8 (15.38)12 (23.08)10 (19.23)
孕前BMI(kg/m2c0.1440.9310.9700.616
<18.57 (13.46)8 (15.38)8 (15.38)7 (13.46)
18.5~23.938 (73.08)38 (73.08)36 (69.23)40 (76.92)
≥247 (13.46)6 (11.54)8 (15.38)5 (9.62)
孕妇最高学历5.5180.0635.5180.063
高中及以下1 (1.92)5 (9.62)3 (5.77)3 (5.77)
大专/大学42 (80.77)32 (61.54)32 (61.54)42 (80.77)
研究生及以上9 (17.31)15 (28.85)17 (32.69)7 (13.46)
家庭人均月收入(元)d2.9200.2329.2800.010
<6 0003 (5.77)6 (11.54)6 (11.54)3 (5.77)
6 000~8 00013 (25.00)7 (13.46)4 (7.69)16 (30.77)
>8 00036 (69.23)39 (75.00)42 (80.77)33 (63.46)
怀孕次数(次)0.3860.8241.3340.513
125 (48.08)28 (53.85)24 (46.15)29 (55.77)
215 (28.85)14 (26.92)17 (32.69)12 (23.08)
≥312 (23.08)10 (19.23)11 (21.15)11 (21.15)
生产次数(次)0.2320.8912.7780.249
139 (75.00)41 (78.85)39 (75.00)41 (78.85)
212 (23.08)10 (19.23)13 (25.00)9 (17.31)
≥31 (1.92)1 (1.92)02 (3.85)
谷类摄入量(g/d)170.5
(92.6, 226.1)
157.0
(111.4, 243.7)
-1.0800.280146.9
(103.6, 231.4)
181.8
(111.4, 233.1)
-1.0470.295
薯类摄入量(g/d)29.3
(10.0, 64.1)
27.7
(11.0, 66.1)
-0.0030.99726.1
(9.3, 50.3)
32.3
(11.6, 86.1)
-1.3140.189
肉类摄入量(g/d)72.2
(46.4, 103.6)
84.3
(51.8, 128.6)
-0.3880.57971.5
(46.5, 119.3)
56.1
(31.7, 94.4)
1.2780.201
水产摄入量(g/d)35.7
(14.2, 60.5)
42.0
(17.2, 141.3)
-1.3750.17040.0
(14.2, 92.4)
37.4
(16.4, 104.5)
-0.3410.733
蔬菜摄入量(g/d)45.0
(35.0, 64.3)
146.0
(105.0, 190.2)
-8.745<0.001101.4
(58.6, 115.7)
76.1
(42.9, 132.1)
1.7760.076
水果摄入量(g/d)200.0
(80.0, 228.6)
144.1
(94.9, 209.7)
0.4070.68489.1
(52.08, 112.5)
221.0
(203.1, 305.7)
-8.758<0.001
坚果摄入量(g/d)8.8
(1.4, 18.0)
5.3
(0.6, 16.5)
0.8490.3964.9
(1.9, 11.5)
10.0
(0.5, 22.3)
-1.1830.237
奶及奶制品摄入量(g/d)220.0
(111.4, 300.0)
250.0
(128.6, 300.0)
-0.8730.383200.0
(85.7, 300.0)
250.0
(150.0, 300.0)
-1.9170.056
豆及豆制品摄入量(g/d)8.7
(3.2, 18.9)
9.6
(3.0, 16.9)
-0.1270.9008.4
(3.1, 17.0)
9.1
(3.2, 18.1)
-0.2890.772
蛋类摄入量(g/d)60.0
(30.0, 60.0)
60.0
(42.9, 60.0)
-1.0800.28060.1
(42.9, 60.0)
60.0
(27.9, 60.0)
0.1920.848
能量摄入(kcal/d)1 456.5
(1 197.8, 1 878.6)
1 706.1
(1 343.4, 2 155.7)
-2.2200.0261 530.4
(1 156.2, 1 882.7)
1 568.6
(1 416.6, 1 959.8)
-1.2320.218
), ArticleFig(id=1240972175738467294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=CN, label=表1, caption=

研究对象基本信息(n=104)a

, figureFileSmall=null, figureFileBig=null, tableContent=
特征蔬菜摄入量bχ2/ZP水果摄入量bχ2/ZP
低 (n=52)高 (n=52)低 (n=52)高 (n=52)
年龄(岁)2.8690.2381.0460.593
<3011 (21.15)9 (17.31)8 (15.38)12 (23.08)
30~3427 (51.92)35 (67.31)32 (61.54)30 (57.69)
≥3514 (26.92)8 (15.38)12 (23.08)10 (19.23)
孕前BMI(kg/m2c0.1440.9310.9700.616
<18.57 (13.46)8 (15.38)8 (15.38)7 (13.46)
18.5~23.938 (73.08)38 (73.08)36 (69.23)40 (76.92)
≥247 (13.46)6 (11.54)8 (15.38)5 (9.62)
孕妇最高学历5.5180.0635.5180.063
高中及以下1 (1.92)5 (9.62)3 (5.77)3 (5.77)
大专/大学42 (80.77)32 (61.54)32 (61.54)42 (80.77)
研究生及以上9 (17.31)15 (28.85)17 (32.69)7 (13.46)
家庭人均月收入(元)d2.9200.2329.2800.010
<6 0003 (5.77)6 (11.54)6 (11.54)3 (5.77)
6 000~8 00013 (25.00)7 (13.46)4 (7.69)16 (30.77)
>8 00036 (69.23)39 (75.00)42 (80.77)33 (63.46)
怀孕次数(次)0.3860.8241.3340.513
125 (48.08)28 (53.85)24 (46.15)29 (55.77)
215 (28.85)14 (26.92)17 (32.69)12 (23.08)
≥312 (23.08)10 (19.23)11 (21.15)11 (21.15)
生产次数(次)0.2320.8912.7780.249
139 (75.00)41 (78.85)39 (75.00)41 (78.85)
212 (23.08)10 (19.23)13 (25.00)9 (17.31)
≥31 (1.92)1 (1.92)02 (3.85)
谷类摄入量(g/d)170.5
(92.6, 226.1)
157.0
(111.4, 243.7)
-1.0800.280146.9
(103.6, 231.4)
181.8
(111.4, 233.1)
-1.0470.295
薯类摄入量(g/d)29.3
(10.0, 64.1)
27.7
(11.0, 66.1)
-0.0030.99726.1
(9.3, 50.3)
32.3
(11.6, 86.1)
-1.3140.189
肉类摄入量(g/d)72.2
(46.4, 103.6)
84.3
(51.8, 128.6)
-0.3880.57971.5
(46.5, 119.3)
56.1
(31.7, 94.4)
1.2780.201
水产摄入量(g/d)35.7
(14.2, 60.5)
42.0
(17.2, 141.3)
-1.3750.17040.0
(14.2, 92.4)
37.4
(16.4, 104.5)
-0.3410.733
蔬菜摄入量(g/d)45.0
(35.0, 64.3)
146.0
(105.0, 190.2)
-8.745<0.001101.4
(58.6, 115.7)
76.1
(42.9, 132.1)
1.7760.076
水果摄入量(g/d)200.0
(80.0, 228.6)
144.1
(94.9, 209.7)
0.4070.68489.1
(52.08, 112.5)
221.0
(203.1, 305.7)
-8.758<0.001
坚果摄入量(g/d)8.8
(1.4, 18.0)
5.3
(0.6, 16.5)
0.8490.3964.9
(1.9, 11.5)
10.0
(0.5, 22.3)
-1.1830.237
奶及奶制品摄入量(g/d)220.0
(111.4, 300.0)
250.0
(128.6, 300.0)
-0.8730.383200.0
(85.7, 300.0)
250.0
(150.0, 300.0)
-1.9170.056
豆及豆制品摄入量(g/d)8.7
(3.2, 18.9)
9.6
(3.0, 16.9)
-0.1270.9008.4
(3.1, 17.0)
9.1
(3.2, 18.1)
-0.2890.772
蛋类摄入量(g/d)60.0
(30.0, 60.0)
60.0
(42.9, 60.0)
-1.0800.28060.1
(42.9, 60.0)
60.0
(27.9, 60.0)
0.1920.848
能量摄入(kcal/d)1 456.5
(1 197.8, 1 878.6)
1 706.1
(1 343.4, 2 155.7)
-2.2200.0261 530.4
(1 156.2, 1 882.7)
1 568.6
(1 416.6, 1 959.8)
-1.2320.218
), ArticleFig(id=1240972175855907810, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=EN, label=Table 2, caption=

The α diversity index stratified by vegetable and fruit intake in the first trimester of pregnancy (n=104)

, figureFileSmall=null, figureFileBig=null, tableContent=
α多样性蔬菜摄入量bZP水果摄入量bZP
低 (n=52)高 (n=52)低 (n=52)高 (n=52)
Chao1指数396.73
(241.91, 774.34)
525.78
(273.18, 1 292.68)
-1.0410.161378.72
(252.01, 1 060.21)
520.78
(254.96, 981.28)
-0.8740.382
Pielou指数0.67
(0.62, 0.75)
0.71
(0.65, 0.74)
-1.1800.2380.70
(0.64, 0.73)
0.70
(0.64, 0.76)
-0.6700.503
Shannon指数5.75
(5.15, 6.77)
6.45
(5.33, 7.39)
-1.5180.1295.90
(5.28, 7.00)
6.17
(5.18, 7.01)
-0.5820.561
Simpson指数0.95
(0.91, 0.97)
0.97
(0.93, 0.98)
-1.8790.0600.95
(0.93, 0.97)
0.95
(0.92, 0.98)
-0.2800.780
), ArticleFig(id=1240972175973348331, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=CN, label=表2, caption=

孕早期蔬菜水果不同摄入量组肠道菌群α多样性对比(n=104)a

, figureFileSmall=null, figureFileBig=null, tableContent=
α多样性蔬菜摄入量bZP水果摄入量bZP
低 (n=52)高 (n=52)低 (n=52)高 (n=52)
Chao1指数396.73
(241.91, 774.34)
525.78
(273.18, 1 292.68)
-1.0410.161378.72
(252.01, 1 060.21)
520.78
(254.96, 981.28)
-0.8740.382
Pielou指数0.67
(0.62, 0.75)
0.71
(0.65, 0.74)
-1.1800.2380.70
(0.64, 0.73)
0.70
(0.64, 0.76)
-0.6700.503
Shannon指数5.75
(5.15, 6.77)
6.45
(5.33, 7.39)
-1.5180.1295.90
(5.28, 7.00)
6.17
(5.18, 7.01)
-0.5820.561
Simpson指数0.95
(0.91, 0.97)
0.97
(0.93, 0.98)
-1.8790.0600.95
(0.93, 0.97)
0.95
(0.92, 0.98)
-0.2800.780
), ArticleFig(id=1240972176103371762, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=EN, label=Table 3, caption=

Multiple linear regression analysis of the relationship between the intake of vegetables and fruits and gut microbiota in the first trimester of pregnancy (n=104)

, figureFileSmall=null, figureFileBig=null, tableContent=
模型 1b模型 2c
β (95%CI)Pdβ (95%CI)Pd
蔬菜类
Eubacterium siraeum group0.007(0.003, 0.012)0.0030.007(0.002, 0.012)0.012
Bacteroides-0.134(-0.254, -0.013)0.045-0.167(-0.300, -0.034)0.023
Bilophila-0.002(-0.004, 0.000 3)0.095-0.002(-0.004, 0.001)0.130
水果类
Akkermansia0.002(-0.007, 0.010)0.7250.001(-0.009, 0.010)0.899
Ruminococcus gnavus group0.004(0.001, 0.007)0.0280.004(0.001, 0.007)0.034
Dialister-0.014(-0.033, 0.005)0.187-0.014(-0.034, 0.006)0.217
Agathobacter-0.021(-0.036, -0.005)0.036-0.021(-0.037, -0.005)0.044
), ArticleFig(id=1240972176220812282, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240950905248469809, language=CN, label=表3, caption=

孕早期蔬菜水果摄入与肠道菌群关系的多重线性回归(n=104)a

, figureFileSmall=null, figureFileBig=null, tableContent=
模型 1b模型 2c
β (95%CI)Pdβ (95%CI)Pd
蔬菜类
Eubacterium siraeum group0.007(0.003, 0.012)0.0030.007(0.002, 0.012)0.012
Bacteroides-0.134(-0.254, -0.013)0.045-0.167(-0.300, -0.034)0.023
Bilophila-0.002(-0.004, 0.000 3)0.095-0.002(-0.004, 0.001)0.130
水果类
Akkermansia0.002(-0.007, 0.010)0.7250.001(-0.009, 0.010)0.899
Ruminococcus gnavus group0.004(0.001, 0.007)0.0280.004(0.001, 0.007)0.034
Dialister-0.014(-0.033, 0.005)0.187-0.014(-0.034, 0.006)0.217
Agathobacter-0.021(-0.036, -0.005)0.036-0.021(-0.037, -0.005)0.044
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孕早期蔬菜和水果摄入与肠道菌群的关系
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张可馨 1 , 王一迪 1 , 刘雪婷 1 , 徐裕杰 2 , 张琴 1 , 田野 1 , 何春雷 1 , 毛泳雯 1 , 成果 2, 3
现代预防医学 | 儿少卫生与妇幼保健 2024,51(7): 1222-1228
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现代预防医学 | 儿少卫生与妇幼保健 2024, 51(7): 1222-1228
孕早期蔬菜和水果摄入与肠道菌群的关系
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张可馨1, 王一迪1, 刘雪婷1, 徐裕杰2, 张琴1, 田野1, 何春雷1, 毛泳雯1, 成果2, 3
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
  • 2.四川大学华西第二医院西部妇幼医学研究院妇儿营养中心,四川 成都 610041
  • 3.四川大学华西护理学院,四川 成都 610041
  • 张可馨(1998—),女,硕士在读,研究方向:流行病与卫生统计学

通讯作者:

成果,E-mail:
Association of vegetable and fruit intake with gut microbiota during the first trimester of pregnancy
Ke-xin ZHANG1, Yi-di WANG1, Xue-ting LIU1, Yu-jie XU2, Qin ZHANG1, Ye TIAN1, Chun-lei HE1, Yong-wen MAO1, Guo CHENG2, 3
Affiliations
  • West China School of Public Health, Sichuan University/West China Fourth Hospital, Chengdu, Sichuan 610041, China
出版时间: 2024-04-10 doi: 10.20043/j.cnki.MPM.202311470
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目的

探讨成都市孕早期妇女蔬菜和水果摄入与肠道菌群组成及多样性之间的关系。

方法

本研究纳入104例成都市孕早期妇女,使用膳食频率问卷收集其蔬菜和水果摄入情况,并分别依据蔬菜、水果摄入量中位数将孕早期妇女分为摄入量高组和摄入量低组。使用16S rRNA高通量测序检测孕早期妇女粪便样本肠道菌群,比较组间肠道菌群差异。采用多重线性回归探讨蔬菜、水果摄入和孕早期妇女肠道菌群的关系。

结果

孕早期妇女蔬菜和水果摄入量中位数分别是90.0 g/d和200.0 g/d。孕早期蔬菜、水果摄入高低组孕早期妇女肠道菌群α多样性和β多样性无统计学差异。LEfSe分析显示,孕早期妇女多个肠道菌群的相对丰度在蔬菜、水果摄入量高低组间存在显著差异(P<0.01)。多重线性回归分析显示,在调整了年龄、孕前体质指数和能量摄入后,孕早期妇女蔬菜摄入量与Eubacterium siraeum group相对丰度呈正比(β=0.007, P=0.012),与Bacteroides相对丰度呈反比(β=-0.167, P=0.023);水果摄入量与Ruminococcus gnavus group相对丰度呈正比(β=0.004, P=0.034),与Agathobacter相对丰度呈反比(β=0.004, P=0.044)。

结论

孕早期蔬菜、水果摄入引起肠道菌群相对丰度的变化,本研究为孕期膳食调控肠道菌群提供新的科学依据。

肠道菌群  /  孕早期  /  蔬菜  /  水果  /  16S rRNA
Objective

To investigate the relationship between the intake of vegetables and fruits and the composition and diversity ofgut microbiota during the first trimester of pregnancy in Chengdu.

Methods

In total 104 early pregnant women in Chengdu were enrolled in this study. Dietary frequency questionnaire was used to collect the intake of vegetables and fruits. According to the median intake of vegetables and fruits, the early pregnant women were divided into high intake group and low intake group. The intestinal microflora of fecal samples of early pregnant women was detected by 16S rRNA highthroughput sequencing, and the differences of intestinal microflora between groups were compared. Multiple linear regression was used to explore the relationship between vegetable and fruit intake and intestinal flora in early pregnant women.

Results

The median intake of vegetables and fruits in early pregnant women was 90.0 g/d and 200.0 g/d, respectively. There was no significant difference in intestinal microflora α and β diversity between high and low intake of vegetables and fruits in early pregnancy. LEfSe analysis showed that the relative abundance of multiple intestinal microflorae in early pregnant women was significantly different between the groups with high and low intake of vegetables and fruits. Multiple linear regression analysis showed that after adjusting age, pre-pregnancy body mass index, and energy intake, early pregnant women’s vegetable intake was directly proportional to the relative abundance of Eubacterium siraeum group (β=0.007, P=0.012), inversely proportional to the relative abundance of Bacteroides (β=-0.167, P=0.023), and fruit intake was proportional to the relative abundance of Ruminococcus gnavus group (β=0.004, P=0.034), inversely proportional to the relative abundance of Agathobacter (β=0.004, P=0.044).

Conclusion

The intake of vegetables and fruits in early pregnancy leads to the change of relative abundance of intestinal flora. This study provides a new scientific basis for dietary regulation of gut microbiota during pregnancy.

Gut microbiota  /  Early pregnancy  /  Vegetables  /  Fruits  /  16S rRNA
张可馨, 王一迪, 刘雪婷, 徐裕杰, 张琴, 田野, 何春雷, 毛泳雯, 成果. 孕早期蔬菜和水果摄入与肠道菌群的关系. 现代预防医学, 2024 , 51 (7) : 1222 -1228 . DOI: 10.20043/j.cnki.MPM.202311470
Ke-xin ZHANG, Yi-di WANG, Xue-ting LIU, Yu-jie XU, Qin ZHANG, Ye TIAN, Chun-lei HE, Yong-wen MAO, Guo CHENG. Association of vegetable and fruit intake with gut microbiota during the first trimester of pregnancy[J]. Modern Preventive Medicine, 2024 , 51 (7) : 1222 -1228 . DOI: 10.20043/j.cnki.MPM.202311470
肠道菌群在维持宿主正常生理功能方面发挥重要作用。孕期激素水平、免疫和膳食改变都可能影响肠道菌群[1]。近期研究表明,部分肠道菌群的改变在孕早期就已经凸显[2-3]。孕期肠道菌群的变化不仅与母体妊娠期并发症和妊娠结局相关[4-5],还会影响子代的健康[6],维持孕早期肠道菌群均衡至关重要。膳食摄入作为可改变因素在维持肠道菌群平衡方面发挥重要作用。《中国居民膳食指南2022》[7]中提出,孕早期妇女每日应摄入300~500g蔬菜和200~300g水果以满足孕早期营养需求。此外,孕期蔬菜和水果的摄入还可能与妊娠期并发症降低相关。针对伊朗1 026名妊娠妇女的前瞻性研究发现孕期食用蔬菜和水果是妊娠期糖尿病的保护因素[8],在中国妊娠妇女中也发现蔬菜和水果摄入较高的膳食模式能够显著降低先兆子痫的发生率[9],但目前关于蔬菜、水果摄入对妊娠期并发症的影响机制尚不明确。蔬菜、水果对肠道菌群的影响已在多项前瞻性研究中证明[10-11],蔬菜、水果的摄入可能通过影响肠道菌群的组成及多样性,进而降低代谢性疾病的发病风险[12]。然而,目前关于孕期蔬菜和水果摄入与肠道菌群的关系研究较少[13-14],尚无统一定论,且孕早期的研究较为缺乏。
因此,本研究旨在探讨孕早期妇女蔬菜和水果摄入与肠道菌群的关系,为指导孕早期妇女平衡膳食、改善肠道微生态、降低妊娠期并发症和不良妊娠结局发生风险提供理论基础。
本研究纳入2022年8月—2023年5月在成都市某医院建档的孕早期妇女为研究对象。纳入标准:(1)孕12+0~15+0周内建档;(2)单胎妊娠;(3)能够规律产检且产检记录完整。排除标准:(1)孕前患有糖尿病、高血压、癌症等疾病;(2)孕前三个月及孕期内服用过抗生素。本研究共获得106名研究对象,在排除膳食信息不完整者(n=1)和能量误报者(总能量摄入<500 kcal/d或>3 500 kcal/d)[15]n=1)后,最终纳入104名孕早期妇女。本研究已得到四川大学伦理委员会的批准,所有研究对象均已签署知情同意书。
采用面对面问卷调查的方式于孕12+0~15+0周时收集研究对象的基本信息及孕早期(孕1+0~12+0周)膳食摄入情况。基本信息包括研究对象的社会人口学特征、孕产史、既往史等。膳食摄入情况采用食物频率问卷收集研究对象在孕早期不同食物类别的摄入频率及每次摄入量,并使用统一的标准餐具、膳食图谱和包装食品附图以提高食物份量估计的准确性。根据摄入频率和每次摄入量计算蔬菜和水果每日摄入量(g/d),并使用《中国食物成分表》[16]计算单日能量摄入均值(kcal/d)。
研究对象的孕期体格数据统一由医院医务工作者采用标准方法进行采集,包括身高(精确到0.1 cm)、建档及每次产检时体重(精确到0.1 kg)。孕前体重基于研究对象的自我报告。孕前体质指数(BMI,kg/m2)分类标准参照《妊娠期妇女体重增长推荐值标准》[17]
研究对象在完成问卷调查的当日进行粪便样本的采集,使用无菌粪便采集管采集新鲜且未经尿液或其他液体污染的粪便,交由调查员置于-80℃冰箱储存。采用磁珠法土壤和粪便基因组DNA提取试剂盒(TianGen)对基因组DNA进行提取,使用1%琼脂糖凝胶电泳检测DNA的纯度和浓度。采用引物341F:CCTAYGGGRBGCASCAG和806R: GGACTACHVGG GTWTCTAAT对16S rRNA基因V3-V4可变区进行PCR扩增。纯化及定量后使用Illumina NovaSeq 6000 PE250(Illumina, San Diego, USA)进行测序。使用QIIME2(Version QIIME2-202006)软件中的DADA2模块进行降噪,从而获得最终的扩增子序列变异,并通过QIIME2软件与Silva 138.1数据库比对进行物种注释。
采用SAS 9.4对数据进行统计学处理。连续变量经正态性检验均不服从正态分布,使用中位数和四分位数描述,分类变量采用频数和百分比描述。连续变量组间比较采用Wilcoxon秩和检验,分类变量组间比较采用χ2检验。
肠道菌群分析采用QIIME2和R(4.3.0)对测序结果进行分析并进行可视化。菌群α多样性指数使用QIIME2计算,β多样性分析采用基于Bray-Curtis距离的主坐标分析法(principal co-ordinates analysis,PCoA),并采用PERMANOVA检验判断组间差异是否具有统计学意义。采用线性判别分析效应量(linear discriminant analysis effect size,LEfSe)揭示不同摄入水平组之间的肠道菌群物种差异,运用线性判别分析(linear discriminant analysis,LDA)筛选组间具有显著差异的特征菌(LDA阈值>2.0)。将筛选出的在属水平上的特征菌分别纳入多重线性回归模型,并纳入孕期肠道菌群的重要影响因素(年龄、孕前BMI)以及在组间显示出差异的因素(能量摄入)作为混杂因素。蔬菜水果摄入量按照每500 g为一个变化单位进行调整,使用Benjamini-Hochberg法对多重检验后的P值进行校正。所有统计学检验均为双侧检验,检验水准α=0.05。
本研究共纳入104名孕早期妇女,中位年龄为32.00(30.00,32.50)岁,孕前BMI中位数为20.90(19.19,22.64)kg/m2,均来自城镇地区。孕早期妇女每日蔬菜摄入量中位数为90.0 g/d,每日水果摄入量中位数为200.0 g/d。蔬菜摄入量高的孕早期妇女每日能量摄入高于摄入量低组的妇女(P=0.03),水果摄入量高组和低组孕早期妇女家庭人均月收入存在差异(P=0.01),其他变量无统计学意义。见表1
采用Chao1指数、Pielou指数、Shannon指数和Simpson指数分别从肠道菌群丰富度和均匀度方面评估蔬菜摄入量和水果摄入量高低组间α多样性差异。结果发现各组间差异均无统计学意义,见表2
采用基于Bray-Curtis距离的PCoA法对不同样本的微生物群落结构进行β多样性分析,结果见图1,蔬菜摄入量和水果摄入量高低两组间在第一、二主成分上均未呈现出明显的分离趋势。PERMANOVA检验结果显示,蔬菜和水果摄入对肠道菌群组成未产生显著影响。
通过LEfSe分析筛选不同摄入量组具有显著差异的特征菌。结果显示,从门水平至属水平,蔬菜摄入量和水果摄入量高低组均观察到相对丰度具有显著差异的特征菌,见图2。蔬菜摄入量低组的特征菌较多,包括拟杆菌门(Bacteroidota)、脱硫菌门(Desulfobacterota)、拟杆菌纲(Bacteroidia)、Desulfovibrionia、拟杆菌目(Bacteroidales)、脱硫弧菌目(Desulfovibrionales)、拟杆菌科(Bacteroidaceae)、脱硫弧菌科(Desulfovibrionaceae)、拟杆菌属(Bacteroides)和嗜胆菌属(Bilophila);在蔬菜摄入量高组Eubacterium siraeum group相对丰度较高。水果摄入量低组的特征菌包括革兰阴性菌纲(Negativicutes)、Veillonellales Selenomonadales、韦荣菌科(Veillonellaceae)、小杆菌属(Dialister)和琼脂杆菌属(Agathobacter);水果摄入量高组识别出红螺菌目(Rhodospirillales)、阿克曼菌科(Akkermansiaceae)、AkkermansiaRuminococcus gnavus group
菌属是生物学分类中较为具体的分类级别,因此本研究进一步将LEfSe分析中筛选出的在属水平上有显著差异的菌纳入多重线性回归模型,见表3。结果显示在调整了年龄、孕前BMI和能量摄入后,蔬菜摄入量与Eubacterium siraeum group呈正相关(β=0.007,P=0.012),与Bacteroides呈负相关(β=-0.167,P=0.023);水果摄入量与Ruminococcus gnavus group呈正相关(β=0.004,P=0.034),与Agathobacter呈负相关(β=-0.021,P=0.044)。
本研究发现不同蔬菜、水果摄入量组的孕早期妇女肠道菌群存在差异。在属水平上的多重线性回归分析显示,在调整年龄、孕前BMI、能量摄入后,孕早期妇女蔬菜摄入量越高,肠道中Eubacterium siraeum group的相对丰度越高,Bacteroides的相对丰度越低;水果摄入量越高,肠道中Ruminococcus gnavus group相对丰度越高,Agathobacter相对丰度越低。
本研究发现孕早期妇女蔬菜摄入增加与Eubacterium siraeum group的相对丰度较高有关。Eubacterium siraeum group可以利用蔬菜中丰富的膳食纤维产生短链脂肪酸[19],通过交叉喂养机制增加本组中多个菌的相对丰度[20],这或许可以解释蔬菜摄入量较高的妇女肠道中Eubacterium siraeum group的相对丰度较高。Eubacterium siraeum group属于厚壁菌门,由与Eubacterium siraeum相似的菌富集成组,Eubacterium siraeum参与亚油酸的代谢[21],代谢过程中产生的共轭亚油酸与降低肥胖、肿瘤、心血管疾病发生风险等多种健康益处相关[22]。我国一项病例对照研究显示,与糖耐量正常孕妇相比,妊娠期糖尿病孕妇Eubacterium siraeum丰度较低[23]。本研究发现BacteroidesBilophila在蔬菜摄入低组富集,且蔬菜摄入量与Bacteroides相对丰度呈负相关。蔬菜中含有较多的膳食纤维,在澳大利亚一项孕妇研究中发现了低膳食纤维摄入与Bilophila的较高丰度相关[24],与本研究结果相似。Bilophila为机会致病菌,代谢蛋白底物、牛磺酸及硫酸盐,当膳食中蔬菜摄入量较低、肉类及脂肪摄入量较高时,肠道中的硫酸盐及胆汁酸含量增加,为Bilophila的丰度增加提供了基础[25]
此外,本研究发现,水果摄入量高组在属水平上的特征菌为Akkermansia。在我国的一项队列研究中也发现了水果摄入与Akkermansia相对丰度的正相关关系[12]。水果中富含的多酚等抗氧化物质能够通过增加粘液分泌等方式,为Akkermansia的生长创造有利环境[26]。动物研究发现Akkermansia能够通过抑制炎症反应调节肠道屏障功能,改善子痫前期症状[27]。本研究还发现孕早期妇女水果摄入量越高,肠道中Ruminococcus gnavus group的相对丰度越高。与本研究结果不一致的是,在意大利成人[28]、澳大利亚儿童[29]的研究中发现水果摄入与Ruminococcus gnavus group丰度呈负相关关系,这可能与人种及遗传背景的差异有关,这提示我们膳食与肠道菌群的关系可能受宿主基因的影响。尚未有研究探讨水果摄入引起Ruminococcus gnavus group丰度变化的机制。但我国一项队列研究发现Ruminococcus gnavus group在妊娠期糖尿病孕妇中显著富集,并且通过胰岛素信号通路和脂多糖生物合成途径参与妊娠期糖尿病的发生机制[30]。此外,本研究结果显示DialisterAgathobacter在水果摄入低组显著富集,但目前有关DialisterAgathobacter与水果摄入的研究较少,水果摄入与肠道菌群的关系及机制还需要更多研究探明。
本研究未观察到蔬菜、水果的摄入对于肠道菌群α多样性及β多样性的显著影响,这与我国关于成年居民队列研究的结果一致[12]。然而,在芬兰一项横断面研究中,则发现蔬菜、水果的摄入能改变肠道菌群β多样性,且α多样性与水果摄入呈正相关[31]。蔬菜水果中富含的膳食纤维为肠道微生物的生长和繁殖提供更多底物,维生素、多酚等抗氧化物质也有助于减轻肠道内的氧化应激,提供更适宜的环境供肠道微生物生存[32-33],因此蔬菜、水果的摄入或许能够改变肠道菌群的多样性。但本研究中未观察到肠道菌群多样性的显著区别,可能是由于地域及人种差异导致,孕早期蔬菜、水果摄入与肠道菌群多样性的关系还有待进一步探索。
综上所述,本研究发现了孕早期蔬菜、水果的摄入能够改变肠道中的菌群分布,并且蔬菜、水果摄入量与部分菌群相对丰度存在线性相关关系,为孕期膳食调控肠道菌群提供新的科学依据。然而,本研究存在一些不足之处,孕早期妇女的膳食摄入信息通过膳食频率问卷采集,存在回忆偏倚,本研究在调查过程中使用统一的标准餐具、膳食图谱进行辅助以提高食物份量估计的准确性。此外,本研究采用的16S rRNA测序技术未能精确到肠道菌群的种水平。因此在未来可采用样本量更大覆盖范围更全面的纵向队列继续分析其他食物类别以及营养素是否对于肠道菌群的结果造成混杂,使用宏基因组分析技术探索膳食摄入与疾病的关联,并进一步明确肠道菌群在其中的作用机制。
  • 国家重点研发计划项目(2020YFC2006300)
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2024年第51卷第7期
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doi: 10.20043/j.cnki.MPM.202311470
  • 接收时间:2023-11-25
  • 首发时间:2026-03-18
  • 出版时间:2024-04-10
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  • 收稿日期:2023-11-25
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    1.四川大学华西公共卫生学院/华西第四医院,四川 成都 610041
    2.四川大学华西第二医院西部妇幼医学研究院妇儿营养中心,四川 成都 610041
    3.四川大学华西护理学院,四川 成都 610041

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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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