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有高血压病史的急性缺血性中风患者口腔微生物硝酸盐代谢与预后不良之间的关联

Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension.

作者信息

Ren Yueran, Liang Jingru, Hu Weike, Xie Jiahui, Zheng Yifeng, Song Wei, Zhu Jiajia, Zhou Hongwei, Wu Qiheng, He Yan, Yin Jia

机构信息

Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

出版信息

J Oral Microbiol. 2024 Jul 23;16(1):2382620. doi: 10.1080/20002297.2024.2382620. eCollection 2024.

DOI:10.1080/20002297.2024.2382620
PMID:39055280
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11271073/
Abstract

BACKGROUND

Oral microbes mediate the production of nitric oxide (NO) through the denitrification pathway. This study aimed to investigate the association between oral microbial nitrate metabolism and prognosis in acute ischemic stroke (AIS) patients.

METHODS

This prospective, observational, single-center cohort study included 124 AIS patients admitted within 24 hours of symptom onset, with 24-hour ambulatory blood pressure data. Oral swabs were collected within 24 hours. Hypertensive AIS patients were stratified by the coefficient of variation (CV) of 24-hour systolic blood pressure. Microbial composition was analyzed using LEfSe and PICRUSt2 for bacterial and functional pathway identification.

RESULTS

Significant differences in oral microbiota composition were observed between hypertensive AIS patients with varying CVs. Lower CV groups showed enrichment of nitrate-reducing bacteria and "Denitrification, nitrate => nitrogen" pathways. The TAX score of oral nitrate-reducing bacteria, derived from LASSO modeling, independently correlated with 90-day modified Rankin Scale scores, serving as an independent risk factor for poor prognosis. Mediation analyses suggested indirect that the TAX score not only directly influences outcomes but also indirectly affects them by modulating 24-hour systolic blood pressure CV.

CONCLUSIONS

AIS patients with comorbid hypertension and higher systolic blood pressure CV exhibited reduced oral nitrate-reducing bacteria, potentially worsening outcomes.

摘要

背景

口腔微生物通过反硝化途径介导一氧化氮（NO）的产生。本研究旨在探讨急性缺血性卒中（AIS）患者口腔微生物硝酸盐代谢与预后之间的关联。

方法

这项前瞻性、观察性、单中心队列研究纳入了124例症状发作后24小时内入院且有24小时动态血压数据的AIS患者。在24小时内采集口腔拭子。高血压AIS患者按24小时收缩压变异系数（CV）分层。使用线性判别分析效应大小（LEfSe）和PICRUSt2分析微生物组成，以鉴定细菌和功能途径。

结果

不同CV的高血压AIS患者之间口腔微生物群组成存在显著差异。CV较低的组显示出硝酸盐还原菌和“反硝化作用，硝酸盐→氮气”途径的富集。基于套索回归模型得出的口腔硝酸盐还原菌TAX评分与90天改良Rankin量表评分独立相关，是预后不良的独立危险因素。中介分析表明，TAX评分不仅直接影响预后，还通过调节24小时收缩压CV间接影响预后。

结论

合并高血压且收缩压CV较高的AIS患者口腔硝酸盐还原菌减少，可能导致预后恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/4b8d7fc77d1f/ZJOM_A_2382620_F0009_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/7ea09d9c089c/ZJOM_A_2382620_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/2f3f2173801e/ZJOM_A_2382620_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/f4531d923b55/ZJOM_A_2382620_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/658e3d439e89/ZJOM_A_2382620_F0004_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/ed2fe0d1583e/ZJOM_A_2382620_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/f31cc11ab4c1/ZJOM_A_2382620_F0006_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/9bc3a2964d4e/ZJOM_A_2382620_F0007_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/66a6a5c9c06c/ZJOM_A_2382620_F0008_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/4b8d7fc77d1f/ZJOM_A_2382620_F0009_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/7ea09d9c089c/ZJOM_A_2382620_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/2f3f2173801e/ZJOM_A_2382620_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/f4531d923b55/ZJOM_A_2382620_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/658e3d439e89/ZJOM_A_2382620_F0004_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/ed2fe0d1583e/ZJOM_A_2382620_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/f31cc11ab4c1/ZJOM_A_2382620_F0006_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/9bc3a2964d4e/ZJOM_A_2382620_F0007_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/66a6a5c9c06c/ZJOM_A_2382620_F0008_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/11271073/4b8d7fc77d1f/ZJOM_A_2382620_F0009_B.jpg

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