Grammatopoulos Konstantinos, Antoniou Vaios-Dionysios, Mavrothalassitis Evangelos, Mouziouras Dimitris, Argyris Antonios A, Emmanouil Eleni, Vlachopoulos Charalampos, Protogerou Athanase D
Cardiovascular Prevention and Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece.
1st Department of Cardiology, National and Kapodistrian University of Athens, Greece.
Am Heart J Plus. 2022 Oct 17;23:100219. doi: 10.1016/j.ahjo.2022.100219. eCollection 2022 Nov.
The present systematic review investigates the hypothesis that specific components of the intestinal microbiome and/or their metabolites are associated with early stages of subclinical arterial damage (SAD).
Based on the MOOSE criteria, we conducted a systematic review of the literature (Scopus, Medline) investigating the potential association between gut microbiota and the most widely applied arterial biomarkers of SAD.
All studies included individuals without established cardiovascular disease, either with or without SAD.
No interventions were made.
Association between exposure (components/metabolites of microbiota) and outcome (presence of SAD).
Fourteen articles met the predefined criteria. Due to the large heterogeneity, their meta-analysis was not possible. Our review revealed (a) two studies on endothelial dysfunction, out of which one found an inverse relation between plasma trimethylamine N-oxide levels and FMD and the other did not substantiate a statistically significant correlation with RHI. (b) Twelve studies on atheromatosis, assessed as intimal-medial thickness (IMT), coronary artery calcium (CAC) and arterial plaque, of which, seven studies showed statistically significant associations (negative or positive depending on the microorganism or microbiota metabolite) with IMT, one study revealed significant associations with coronary artery calcium, while one showed absence of correlation and four studies reported statistically significant correlations with arterial plaque. (c) Three studies on arterial stiffness (pulse wave velocity - PWV) with two of them concluding in statistically significant association while the third study did not. Some articles investigated multiple of the correlations described and therefore, belonged to more than one section.
Evidence of both positive and inverse associations of gut microbiota composition and their metabolites with different types of SVD has been found. However the small number and heterogeneity of available studies cannot allow to confirm or disprove the hypothesis.
本系统评价旨在研究肠道微生物群的特定成分和/或其代谢产物与亚临床动脉损伤（SAD）早期阶段相关的假说。
基于MOOSE标准，我们对文献（Scopus、Medline）进行了系统评价，以研究肠道微生物群与SAD最广泛应用的动脉生物标志物之间的潜在关联。
所有研究纳入的个体均无已确诊的心血管疾病，有或无SAD。
未进行干预。
暴露因素（微生物群的成分/代谢产物）与结果（SAD的存在）之间的关联。
14篇文章符合预定义标准。由于异质性较大，无法进行荟萃分析。我们的综述显示：（a）两项关于内皮功能障碍的研究，其中一项发现血浆氧化三甲胺水平与血流介导的舒张功能之间存在负相关，另一项未证实与反应性充血指数有统计学显著相关性。（b）12项关于动脉粥样硬化的研究，评估指标为内膜中层厚度（IMT）、冠状动脉钙化（CAC）和动脉斑块，其中7项研究显示与IMT有统计学显著关联（根据微生物或微生物群代谢产物的不同呈负相关或正相关），1项研究显示与冠状动脉钙化有显著关联，1项研究显示无相关性，4项研究报告与动脉斑块有统计学显著相关性。（c）三项关于动脉僵硬度（脉搏波速度-PWV）的研究，其中两项得出有统计学显著关联的结论，而第三项研究未得出此结论。一些文章研究了上述多种相关性，因此属于多个部分。
已发现肠道微生物群组成及其代谢产物与不同类型的小血管疾病存在正相关和负相关的证据。然而，现有研究数量少且异质性大，无法证实或反驳该假说。
