Department of the Second Clinical Medicine, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Department of Respiratory, Ninth Hospital of Xi'an, Xian, China.
Sci Rep. 2024 Sep 16;14(1):21552. doi: 10.1038/s41598-024-72230-4.
Intestinal microbiota imbalance plays an important role in the progression of obstructive sleep apnea (OSA), and is considered to be the main mediator that triggers metabolic comorbidities. Here, we analyzed the changes in intestinal microbiota in patients with different severities of OSA based on apnea hypopnea index (AHI) classification, and explored the role of intestinal microbiota in the severity of OSA. This study included 19 healthy volunteers and 45 patients with OSA [5 ≤ AHI < 15 (n = 14), 15 ≤ AHI < 30 (n = 13), AHI ≥ 30 (n = 18)]. Relevant sleep monitoring data and medical history data were collected, and microbial composition was analyzed using 16S rRNA high-throughput sequencing technology. The diversity analysis of intestinal microbiota among different groups of people was conducted, including alpha diversity, beta diversity, species diversity, and marker species as well as differential functional metabolic pathway prediction analysis. With the increase of AHI classification, the alpha diversity in patients with OSA significantly decreased. The results revealed that the severity of OSA is associated with differences in the structure and composition of the intestinal microbiota. The abundance of bacteria producing short-chain fatty acids (such as Bacteroides, Ruminococcacea, and Faecalibacterium) in severe OSA is significantly reduced and a higher ratio of Firmicutes to Bacteroidetes. Random forest analysis showed that Parabacteroides was a biomarker genus with important discriminatory significance. The differential metabolic pathway prediction function shows that the main function of maintaining intestinal microbiota homeostasis is biosynthetic function. Our results show that the differences in the composition of intestinal microbiota in patients with different severities of OSA are mainly related to short-chain fatty acid-producing bacteria. These changes may play a pathological role in OSA combined with metabolic comorbidities.
肠道微生物群落失衡在阻塞性睡眠呼吸暂停（OSA）的进展中起着重要作用，被认为是触发代谢合并症的主要介质。在这里，我们根据呼吸暂停低通气指数（AHI）分类分析了不同严重程度 OSA 患者的肠道微生物群落变化，并探讨了肠道微生物群落在 OSA 严重程度中的作用。本研究纳入了 19 名健康志愿者和 45 名 OSA 患者[5≤AHI<15(n=14)、15≤AHI<30(n=13)、AHI≥30(n=18)]。收集了相关的睡眠监测数据和病史数据，并使用 16S rRNA 高通量测序技术分析微生物组成。对不同人群的肠道微生物群落多样性进行分析，包括 alpha 多样性、beta 多样性、物种多样性和标记物种以及差异功能代谢途径预测分析。随着 AHI 分类的增加，OSA 患者的 alpha 多样性显著降低。结果表明，OSA 的严重程度与肠道微生物群落的结构和组成差异有关。严重 OSA 中产生短链脂肪酸（如拟杆菌、瘤胃球菌科和粪杆菌）的细菌丰度显著降低，厚壁菌门与拟杆菌门的比例更高。随机森林分析表明，副拟杆菌是具有重要鉴别意义的标志性属。差异代谢途径预测功能表明，维持肠道微生物群落平衡的主要功能是生物合成功能。我们的结果表明，不同严重程度 OSA 患者肠道微生物群落组成的差异主要与产生短链脂肪酸的细菌有关。这些变化可能与代谢合并症相关的 OSA 发生病理变化有关。
