虽然人工粗粪微生物移植(FMT)可降低高脂血症动物模型的血脂,其对高脂血症和低脂血症患者血脂代谢的临床影响尚不清楚,尤其是中国人。据报道,洗涤微生物群移植(WMT)更安全,更精确,比人工原油质量更可控。本研究旨在探讨WMT对中国人群脂质代谢的可行性和有效性。
收集接受WMT1-3治疗程序的具有各种适应症的患者的临床数据。WMT前后血脂的变化,即,总胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),胰岛素抵抗的稳态模型评估(HOMA-IR),肝脏脂肪衰减,和肝脏硬度测量,进行了比较。
总共177例患者(40例高脂血症,87例血脂正常,广东药科大学第一附属医院收治低脂血症患者50例)。WMT在降低高脂血症患者中、短期血脂(TC和TG)方面有显著的治疗作用(p<0.05)。高血脂短期降至正常(35.14%;p<0.001),LDL-C在中期变为正常(33.33%;p=0.013)。在低脂血症组中,36.36%和47.06%在基于血脂水平的治疗效果的短期(p=0.006)和中期(p=0.005)变为正常。在血脂正常组和动脉粥样硬化性心血管疾病(ASCVD)低危组中,变化没有统计学意义,表明WMT不会长期增加血脂和ASCVD的风险。
WMT治疗可改变高脂血症和低脂血症患者的血脂,无严重不良事件,长期没有增加血脂和ASCVD的风险。有显著降低的TC,TG,和LDL-C水平在WMT治疗高脂血症的中期。因此,WMT对肠道菌群的调节可能为治疗血脂异常提供新的临床方法。
Although the manual crude fecal microbiota transplantation (FMT) reduces blood lipids in animal models of hyperlipidemia, its clinical effect on blood lipid metabolism in patients with hyperlipidemia and
hypolipidemia remains unclear, especially in the Chinese population. It was reported that washed microbiota transplantation (WMT) was safer, more precise, and more quality-controllable than the crude FMT by manual. This study aimed to investigate the feasibility and effectiveness of WMT on lipid metabolism in the Chinese population.
Clinical data of patients with various indications who received WMT for 1-3 treatment procedures were collected. Changes in blood lipids before and after WMT, namely, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), homeostasis model assessment of insulin resistance (HOMA-IR), liver fat attenuation, and liver stiffness measurement, were compared.
A total of 177 patients (40 cases of hyperlipidemia, 87 cases with normal blood lipids, and 50 cases of
hypolipidemia) were enrolled in the First Affiliated Hospital of Guangdong Pharmaceutical University. WMT has a significant therapeutic effect in reducing blood lipid levels (TC and TG) in the short- and medium term in patients with hyperlipidemia (p <0.05). Hyper blood lipid decreased to normal in the short-term (35.14%; p <0.001), and LDL-C changed to normal in the medium term (33.33%; p = 0.013). In the
hypolipidemia group, 36.36% and 47.06% changed to normal in the short-term (p = 0.006) and medium term (p = 0.005) of therapeutic effects based on blood lipid levels. In the normal blood lipid group and the low-risk group of atherosclerotic cardiovascular disease (ASCVD), the change was not statistically significant, indicating that WMT does not increase the risk of blood lipid and ASCVD in the long-term.
WMT treatment changes blood lipids in patients with hyperlipidemia and
hypolipidemia without serious adverse events, with no risk for increasing blood lipids and ASCVD in the long-term. There were significant decreased TC, TG, and LDL-C levels in the medium term of WMT treatment for hyperlipidemia. Therefore, the regulation of gut microbiota by WMT may indicate a new clinical method for the treatment of dyslipidemia.