南方医科大学学报 ›› 2025, Vol. 45 ›› Issue (9): 2034-2045.doi: 10.12122/j.issn.1673-4254.2025.09.23

• • 上一篇    

乙型肝炎病毒-代谢相关脂肪性肝病共病患者脂质代谢紊乱与口腔微生物组及代谢产物变化相关

张晶晶1(), 冯松2(), 张达利1, 薛剑3, 周超1, 刘鹏程1, 付双楠1, 宫嫚1, 冯卉2(), 张宁1()   

  1. 1.中国人民解放军总医院,肝病医学部,北京 100039
    2.中国人民解放军总医院,肿瘤医学部超声诊断科,北京 100039
    3.中国人民解放军总医院,心血管病医学部,北京 100039
  • 收稿日期:2024-12-15 出版日期:2025-09-20 发布日期:2025-09-28
  • 通讯作者: 冯卉,张宁 E-mail:zt2230224@126.com;flying-1984@163.com;fenghui810@126.com;zhangning198191@sina.com
  • 作者简介:张晶晶,主治医师,E-mail: zt2230224@126.com
    冯 松,主治医师,E-mail: flying-1984@163.com
    第一联系人:张晶晶、冯松共同为第一作者
  • 基金资助:
    北京市自然科学基金—海淀原始创新联合基金(L222134)

Altered oral microbiome and metabolites are associated with improved lipid metabolism in HBV-infected patients with metabolic dysfunction-associated fatty liver disease

Jingjing ZHANG1(), Song FENG2(), Dali ZHANG1, Jian XUE3, Chao ZHOU1, Pengcheng LIU1, Shuangnan FU1, Man GONG1, Hui FENG2(), Ning ZHANG1()   

  1. 1.Senior Department of Hepatology, Chinese PLA General Hospital, Beijing 100039, China
    2.Department of Ultrasound, Senior Department of Oncology, Chinese PLA General Hospital, Beijing 100039, China
    3.Senior Department of Cardiology, Chinese PLA General Hospital, Beijing 100039, China
  • Received:2024-12-15 Online:2025-09-20 Published:2025-09-28
  • Contact: Hui FENG, Ning ZHANG E-mail:zt2230224@126.com;flying-1984@163.com;fenghui810@126.com;zhangning198191@sina.com

摘要:

目的 探讨乙型肝炎病毒(HBV)感染对代谢相关脂肪性肝病(MAFLD)患者口腔微生态及代谢物的影响,并分析其潜在机制。 方法 纳入2023年11月~2024年1月本院就诊的单纯MAFLD患者(48例)和合并慢性乙型肝炎患者[MAFLD+慢性乙型病毒性肝炎(CHB)组,47例],采集空腹舌苔样本,结合16S rDNA高通量测序与非靶向代谢组学技术,对比菌群结构及代谢物差异,通过相关性分析和功能注释探讨其与临床指标的关联及生物学通路。 结果 合并CHB组空腹血糖、总胆固醇(TC)、谷氨酰转移酶(GGT)及脂肪肝程度均低于单纯MAFLD组(P<0.05)。菌群分析显示,MAFLD+CHB组Patescibacteria(门水平)、HydrogenophagaAbsconditabacteriales(属水平)丰度升高,Megasphaera丰度降低(P<0.05),且差异菌群与TC、GGT、低密度脂蛋白等指标相关(r=-0.68~0.75,P<0.05)。代谢组学显示,合并CHB组469种代谢物上调(如脂质类、氨基酸类),2306种下调(如有机含氧化合物、苯丙素类),KEGG富集分析显示亚油酸代谢、甘油磷脂代谢通路异常激活(P<0.01)。菌群-代谢物相关性分析显示,Patescibacteria与脂质代谢物正相关,Megasphaera与脂肪酸代谢物负相关(P<0.05),共同影响糖脂代谢及氧化应激通路。 结论 与单纯MAFLD患者相比,合并慢性HBV感染的MAFLD患者部分脂代谢指标及肝脏脂肪变程度较低,同时伴有口腔菌群结构及代谢谱的改变,具体机制尚待进一步研究。

关键词: 乙型肝炎病毒, 代谢相关脂肪性肝病, 口腔微生态, 代谢组学, 脂代谢紊乱, 口腔-肝脏轴

Abstract:

Objective To investigate the impact of hepatitis B virus (HBV) infection on oral microbiota and metabolites in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and the underlying mechanisms. Methods This prospective study was conducted in 47 MAFLD patients complicated with chronic hepatitis B (CHB) and 48 MAFLD patients without CHB enrolled from November, 2023 to January, 2024. Fasting tongue coating samples were collected from the patients for analyzing microbial community structures and metabolites using high-throughput 16S rDNA sequencing and non-targeted metabolomics techniques, and their associations with clinical indicators and biological pathways were explored using correlation analysis and functional annotation. Results The levels of fasting blood glucose, total cholesterol (TC), gamma-glutamyl transferase (GGT), and severity of fatty liver were all significantly lower in MAFLD+CHB group than in MAFLD group. Microbiota analysis showed that the abundances of Patescibacteria (at the phylum level), Hydrogenophaga, and Absconditabacteriales (at the genus level) were significantly increased, while the abundance of Megasphaera was decreased in MAFLD+CHB group. The differential microbiota were significantly correlated with TC, GGT and low-density lipoprotein (r=-0.68‒0.75). Metabolomics analysis revealed that 469 metabolites (including lipids and amino acids) were upregulated and 2306 (including organic oxygen-containing compounds and phenylpropanoids) were downregulated in MAFLD+CHB group, for which KEGG enrichment analysis suggested abnormal activation of the linoleic acid metabolism and glycerophospholipid metabolism pathways. Correlation analysis between microbiota and metabolites indicated that Patescibacteria and Megasphaera, which were positively correlated with lipid metabolites and negatively with fatty acid metabolites, respectively, jointly affected glycolipid metabolism and oxidative stress pathways. Conclusion Compared to patients with MAFLD alone, MAFLD patients with concurrent chronic HBV infection showed lower levels in some lipid metabolism indicators and the degree of hepatic steatosis, accompanied by alterations in oral microbiota structure and metabolic profiles. The precise mechanisms involved require further investigation to be fully elucidated.

Key words: hepatitis B virus, metabolic dysfunction-associated fatty liver disease, oral microbiota, metabolomics, lipid metabolism disorders, oral-liver axis