Department of Geriatric Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing, China.
Department of Microbial Detection, Shaoxing Center for Disease Control and Prevention, Shaoxing, China.
PLoS One. 2024 Aug 6;19(8):e0308360. doi: 10.1371/journal.pone.0308360. eCollection 2024.
Increasing evidence has shown that gut microbiota (GM) was involved in the pathophysiology of musculoskeletal disorders through multiple pathways such as protein anabolism, chronic inflammation and immunity, and imbalanced metabolism. We performed a systematic review and meta-analysis of human studies to evaluate GM diversity differences between individuals with and without sarcopenia, and explore bacteria with potential to become biomarkers. PubMed, Embase and Cochrane library were systematically searched from inception to February 16, 2024. Studies were included if they (1) sampled adults with sarcopenia, and (2) performed GM analysis and reported α-diversity, β-diversity or relative abundance. The methodological quality of included studies and the certainty of evidence were assessed through the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) Working Group system, respectively. Weighted standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs) were estimated for α-diversity indices using a fixed-effects and a random-effects model. Beta diversity and the relative abundance of GM were summarized qualitatively. A total of 19 studies involving 6,565 participants were included in this study. Compared with controls, significantly moderate decrease in microbial richness in participants with sarcopenia were found (Chao1: SMD = -0.44; 95%CI, -0.64 to -0.23, I2 = 57.23%, 13 studies; observed species: SMD = -0.68; 95%CI, -1.00 to -0.37, I2 = 66.07%, 5 studies; ACE index: SMD = -0.30; 95%CI, -0.56 to -0.04, I2 = 8.12%, 4 studies), with very low certainty of evidence. Differences in β-diversity were consistently observed in 84.6% of studies and 97.3% of participants. The detailed analysis of the gut microbial differential abundance identified a loss of Prevotellaceae, Prevotella, and Megamonas in sarcopenia compared with non-sarcopenia. In conclusion, sarcopenia was found to be associated with reduced richness of GM, and supplementing intestinal bacteria described above may contribute to preventing and treating this muscle disease. The research protocol was registered and approved in PROSPERO (CRD42023412849).
越来越多的证据表明，肠道微生物群（GM）通过多种途径参与了肌肉骨骼疾病的病理生理学，如蛋白质合成代谢、慢性炎症和免疫以及代谢失衡。我们对人类研究进行了系统评价和荟萃分析，以评估肌少症患者与非肌少症患者之间 GM 多样性的差异，并探索具有成为生物标志物潜力的细菌。我们从成立到 2024 年 2 月 16 日，系统地检索了 PubMed、Embase 和 Cochrane 图书馆。如果研究符合以下条件，则被纳入：（1）纳入肌少症成年人；（2）进行 GM 分析并报告 α-多样性、β-多样性或相对丰度。通过 Joanna Briggs 研究所分析性横断面研究的批判性评价清单和推荐、评估、制定和评估（GRADE）工作组系统分别评估纳入研究的方法学质量和证据确定性。使用固定效应和随机效应模型估计 α-多样性指数的加权标准化均数差（SMD）和相应的 95%置信区间（CI）。β多样性和 GM 的相对丰度以定性方式总结。本研究共纳入了 19 项研究，涉及 6565 名参与者。与对照组相比，肌少症患者的微生物丰富度显著降低（Chao1：SMD = -0.44；95%CI，-0.64 至-0.23，I2 = 57.23%，13 项研究；观察物种：SMD = -0.68；95%CI，-1.00 至-0.37，I2 = 66.07%，5 项研究；ACE 指数：SMD = -0.30；95%CI，-0.56 至-0.04，I2 = 8.12%，4 项研究），证据确定性极低。84.6%的研究和 97.3%的参与者一致观察到β多样性的差异。对肠道微生物差异丰度的详细分析发现，与非肌少症相比，肌少症中普雷沃氏菌科、普雷沃氏菌属和 Megamonas 的丰度降低。总之，肌少症与 GM 丰富度降低有关，补充上述肠道细菌可能有助于预防和治疗这种肌肉疾病。该研究方案已在 PROSPERO（CRD42023412849）中注册和批准。
