Analysis of intestinal flora diversity and metabolic characteristics in patients with ulcerative colitis complicated with
clostridium difficile infection Xiang Dao* ，Zhou Anfu，Li Yanjuan，Gao Fei． * Department of Clinical Laboratory，the
First Affiliated Hospital of Hainan Medical College，Hainan Province，Haikou 570100，China
Corresponding author: Xiang Dao，E-mail: zjsr6651@ 163． com
Funding program: Hainan Health Industry Scientific Ｒesearch Project( 20A200370)
【Abstract】 Objective To analyze the diversity of intestinal flora in patients with ulcerative colitis complicated with
clostridium difficile infection and its influence on glucose and lipid metabolism． Methods From January 2018 to December
2021，84 patients with ulcerative colitis complicated with clostridium difficile infection were selected as the infection group，
and 91 patients with active ulcerative colitis ( non-infected group) and 104 patients with non-ulcerative colitis ( control group)
were selected for the same period． The clinical data，glycolipid metabolism index ( total cholesterol ( TC) ，triacylglycerol
( TG) Low density lipoprotein cholesterol ( LDL-C) ，high density lipoprotein cholesterol ( HDL-C) ，fasting blood glucose
( FPG) ，intestinal microflora diversity ( Chao1 index，Ace index，Simpson index，Shannon index) and distribution differ-
ences． Spearman method was used to analyze the correlation between metabolic indicators and the diversity of different micro-
flora． Ｒesults Compared with the serum TC and TG levels，the infected group was lower than the non-infected group and
lower than the control group ( F / P = 20． 051 / ＜ 0． 001，26． 321 / ＜ 0． 001) ． Compared with the Chao1 index，Ace index and
Shannon index，the infected group was lower than the non-infected group than the control group ( F / P = 176． 245 / ＜ 0． 001，
254． 463 / ＜ 0． 001，247． 447 / ＜ 0． 001) ，while the Simpson index was higher than the non-infected group than the control
group ( F / P = 105． 363 / ＜ 0． 001) ． Compared with the control group，the abundance of Shigella and Escherichia in the non-
·003· 疑难病杂志 2023 年 3 月第 22 卷第 3 期 Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

infected group was higher，and bifidobacteria，lactobacillus，Bacteroides and Eubacterium were decreased ( LDA ＞ 2log10，P
＜ 0． 05) ． Compared with non-infected group，Bacteroides，Proteus，Clostridium and Bacillus increased in the infected group，
while the abundance of Bacteroides and Citrobacter decreased ( LDA ＞ 2log10，P ＜ 0． 05) ． The correlation analysis showed that
the Chao 1 index，Ace index and Shannon index of patients with ulcerative colitis complicated with clostridium difficile infec-
tion were positively correlated with the levels of TC and TG ( TC: r / P = 0． 614 / ＜ 0． 001，0． 584 / ＜ 0． 001，0． 592 / ＜ 0． 001;
TG: r / P = 0． 604 / ＜ 0． 001，0． 587 / ＜ 0． 001，0． 591 / ＜ 0． 001) ，while Simpson index is negatively correlated with TC and TG
levels( r / P = － 0． 601 / ＜ 0． 001，－ 0． 593 / ＜ 0． 001) ． Conclusions The intestinal flora of patients with ulcerative colitis
complicated with clostridium difficile infection has changed，and the diversity of flora is related to the lipid metabolism of pa-
tients．
【Key words】 Ulcerative colitis; Clostridium difficile; Microbial diversity; Analysis of correlation