The relationships of the severity of rosacea with serum testosterone, estradiol and intestinal flora in rosacea patients
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摘要:目的
探讨玫瑰痤疮严重程度与血清睾酮、雌二醇、肠道菌群的关系。
方法选取2021年3月—2022年9月诊治的102例玫瑰痤疮患者作为观察组，同期105例健康体检志愿者为对照组。根据临床症状严重程度不同，将患者分为轻度组64例、中度组17例、重度组21例。采用放射免疫法检测血清睾酮、雌二醇水平; 荧光定量聚合酶链反应对肠道菌群中双歧杆菌、乳酸杆菌、大肠埃希杆菌、肠球菌的拷贝数进行检测; 采用Pearson相关性分析对玫瑰痤疮患者血清睾酮、雌二醇水平与肠道菌群的相关性进行分析。
结果与对照组[(445.34±68.75) ng/L、(294.25±42.97) pmol/L]比较，观察组玫瑰痤疮患者血清睾酮水平[(547.06±75.13)ng/L]升高，雌二醇[(225.28±25.89) pmol/L]降低，差异有统计学意义(P < 0.05); 观察组玫瑰痤疮男性患者血清雌二醇水平低于对照组男性，女性患者血清睾酮水平高于对照组女性，差异有统计学意义(P < 0.05)。与对照组比较，观察组玫瑰痤疮患者肠道双歧杆菌、乳酸杆菌菌群数量减少，大肠埃希杆菌、肠球菌菌群数量增多, B/E值降低，差异有统计学意义(P < 0.05)。与轻度组比较，中度组、重度组玫瑰痤疮患者血清睾酮水平升高，雌二醇降低，差异有统计学意义(P < 0.05); 重度组较中度组患者血清睾酮水平升高，雌二醇降低，差异有统计学意义(P < 0.05)。Pearson相关性分析结果发现，玫瑰痤疮患者血清睾酮水平与双歧杆菌、乳酸杆菌菌群数量均呈负相关(r=-0.409、-0.485, P < 0.05), 与大肠埃希杆菌、肠球菌菌群数量均呈正相关(r=0.502、0.431, P < 0.05); 血清雌二醇水平与双歧杆菌、乳酸杆菌菌群数量均呈正相关(r=0.417、0.526, P < 0.05), 与大肠埃希杆菌、肠球菌菌群数量均呈负相关(r=-0.481、-0.421, P < 0.05)。
结论玫瑰痤疮患者血清睾酮水平升高、雌二醇水平降低与肠道菌群失调有关，在玫瑰痤疮疾病发生、发展中具有一定作用。
Abstract:ObjectiveTo investigate the relationships of the severity of rosacea with serum testosterone, estradiol and intestinal flora in rosacea patients.
MethodsA total of 102 patients with rosacea diagnosed and treated in our hospital from March 2021 to September 2022 were selected as observation group, and 105 healthy volunteers were selected as control group. According to differed severity of clinical symptoms, the patients were divided into mild group (64 cases), moderate group (17 cases) and severe group (21 cases). Serum testosterone and estradiol levels were detected by radioimmunoassay; the copy numbers of Enterococcus, Escherichia coli, Lactobacillus and Bifidobacterium in intestinal flora were determined by fluorescent quantitative polymerase chain reaction; Pearson correlation analysis was conducted to analyze the correlations of serum testosterone, estradiol levels with intestinal flora in rosacea patients.
ResultsCompared with the control group [(445.34±68.75) ng/L, (294.25±42.97) pmol/L], the serum testosterone level [(547.06±75.13) ng/L]of rosacea patients in the observation group was obviously higher, and the estradiol level [(225.28±25.89) pmol/L] was obviously lower (P < 0.05). The serum estradiol level of males with rosacea in the observation group was obviously lower than that of males in the control group, and the serum testosterone level of females with rosacea in the observation group was obviously higher than that of females in the control group (P < 0.05). Compared with the control group, the number of intestinal Bifidobacteria and Lactobacilli in rosacea patients in the observation group decreased obviously, the number of Escherichia coli and Enterococcus increased obviously, and the B/E decreased (P < 0.05). Compared with mild group, serum testosterone level was increased and estradiol was decreased in moderate and severe groups, and the difference was statistically significant (P < 0.05). Serum testosterone level in the severe group was higher, and estradiol was lower than that in the moderate group, the differences were statistically significant (P < 0.05). Pearson analysis showed that the serum testosterone level in rosacea patients was negatively correlated with the number of Bifidobacteria and Lactobacillus (r=-0.409, -0.485, P < 0.05), and positively correlated with the number of Escherichia coli and Enterococcus (r=0.502, 0.431, P < 0.05); serum estradiol level was positively correlated with the number of Bifidobacteria and Lactobacillus (r=0.417, 0.526, P < 0.05), and negatively correlated with the numbers of Escherichia coli and Enterococcus (r=-0.481, -0.4, 21, P < 0.05).
ConclusionThe increase of serum testosterone level and the decrease of estradiol level in rosette acne patients are related to the imbalance of intestinal flora, and play certain roles in the occurrence and development of rosette acne.
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Keywords:
- rose acne /
- testosterone /
- estradiol /
- Bifidobacterium /
- Lactobacillus /
- Escherichia coli /
- Enterococcus /
- alteration of intestinal flora
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表 1 各菌属引物信息及退火温度
细菌菌属 正向引物5′-3′ 反向引物5′-3′ 退火温度/℃ 扩增片段 双歧杆菌 CTCCTGGAAACGGGTGG GGTGTTCTTCCCGATATCTACA 58 549~563 乳酸杆菌 AGCAGTAGGGAATCTTCCA CACCGCTACACATGGAG 58 341 大肠埃希杆菌 GTTAATACCTTTGCTCATTGA ACCAGGGTATCTAATCCTGTT 58 340 肠球菌 CCCTTATTGTTAGTTGCCATCATT ACTCGTTGTACTTCCCATTGT 52 140 
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表 2 2组血清睾酮、雌二醇水平比较(x±s)
组别 n 睾酮/(ng/L) 雌二醇/(pmol/L) 对照组 105 445.34±68.75 294.25±42.97 观察组 102 547.06±75.13* 225.28±25.89* 与对照组比较, *P < 0.05。
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表 3 不同性别玫瑰痤疮患者血清睾酮、雌二醇水平比较(x±s)
组别 性别 n 睾酮/(ng/L) 雌二醇/(pmol/L) 对照组 男 55 480.12±70.32 194.35±30.17 女 50 407.08±67.02 404.14±57.05 观察组 男 56 504.08±72.67 92.34±19.54* 女 46 599.38±78.12# 387.12±33.62 与对照组男性比较, *P < 0.05; 与对照组女性比较, #P < 0.05。
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表 4 2组菌群情况比较(x±s)
组别 n 双歧杆菌 乳酸杆菌 大肠埃希杆菌 肠球菌 B/E 对照组 105 8.67±1.43 6.44±1.06 6.63±1.02 6.32±0.99 1.31±0.21 观察组 102 6.88±1.14* 5.06±1.11* 7.85±1.11* 7.56±1.15* 0.88±0.10* B/E: 双歧杆菌与大肠埃希杆菌比值。与对照组比较, *P < 0.05。
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表 5 不同程度玫瑰痤疮患者血清睾酮、雌二醇水平比较(x±s)
组别 n 睾酮/(ng/L) 雌二醇/(pmol/L) 轻度组 64 508.58±73.12 246.12±29.12 中度组 17 566.57±75.52* 217.47±24.44* 重度组 21 648.54±80.94*# 168.09±17.22*# 与轻度组比较, *P < 0.05; 与中度组比较, #P < 0.05。
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表 6 玫瑰痤疮患者血清睾酮、雌二醇水平与肠道菌群数量的相关性
指标 双歧杆菌 乳酸杆菌 大肠埃希杆菌 肠球菌 睾酮/(ng/L) r -0.409 -0.485 0.502 0.431 P < 0.05 < 0.05 < 0.05 < 0.05 雌二醇/(pmol/L) r 0.417 0.526 -0.481 -0.421 P < 0.05 < 0.05 < 0.05 < 0.05
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