Guo Wenbin, Sun Lin, Yue Huijun, Guo Xueqin, Chen Lin, Zhang Jinhong, Chen Zhuqi, Wang Yiming, Wang Jiao, Lei Wenbin
Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510080, People's Republic of China.
School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.
Nat Sci Sleep. 2024 Sep 24;16:1483-1495. doi: 10.2147/NSS.S484377. eCollection 2024.
Clinical studies focusing on the association between the gut microbiota and obstructive sleep apnea (OSA) are limited. This study aimed to explore the relationship between intermittent hypoxia and the composition of gut microbiota in adults by analyzing the differences in the characteristics and functional distribution of gut microbiota between patients with different severities of OSA and healthy individuals.
A cohort of 113 individuals from the First Affiliated Hospital of Sun Yat-sen University underwent overnight polysomnography from July 2019 to August 2021. The individuals included 16 healthy controls and 97 patients with OSA, categorized by the apnea-hypopnea index into mild, moderate, and severe groups. Fecal samples were analyzed using high-throughput sequencing of the 16S rRNA V3-V4 region to assess gut microbiota composition and function. Correlation analysis was used to evaluate the association between clinical indicators and microbiota markers.
In patients with OSA, the gut microbiota diversity and the abundance of specific microbes that produce short-chain fatty acids decreased (P<0.05). The phyla Verrucomicrobia and Candidatus Saccharibacteria, genera Gemmiger and Faecalibacterium, and the species Gemmiger formicilis exhibited decreasing abundance with increasing OSA severity. Correlation analysis revealed a robust association between the proportion of total sleep time, characterized by nighttime blood oxygen saturation below 90%, and the alterations in the gut microbiota, demonstrating that elevated levels of desaturation are correlated with pronounced microbiota dysbiosis (P<0.05).
Compared to the control group, the intermittent hypoxia exhibited by patients with OSA may be related to alterations in the composition and structure of the gut microbiota. Our results demonstrate the importance of monitoring hypoxia indicators in future clinical practice.
关注肠道微生物群与阻塞性睡眠呼吸暂停（OSA）之间关联的临床研究有限。本研究旨在通过分析不同严重程度OSA患者与健康个体肠道微生物群特征及功能分布的差异，探讨成年人间歇性缺氧与肠道微生物群组成之间的关系。
2019年7月至2021年8月，中山大学附属第一医院的113名个体接受了整夜多导睡眠监测。这些个体包括16名健康对照者和97名OSA患者，根据呼吸暂停低通气指数分为轻度、中度和重度组。使用16S rRNA V3-V4区域的高通量测序分析粪便样本，以评估肠道微生物群的组成和功能。采用相关性分析评估临床指标与微生物群标志物之间的关联。
在OSA患者中，肠道微生物群多样性以及产生短链脂肪酸的特定微生物丰度降低（P<0.05）。疣微菌门和候选糖菌门、Gemmiger属和粪杆菌属以及甲酸Gemmiger菌的丰度随着OSA严重程度的增加而降低。相关性分析显示，以夜间血氧饱和度低于90%为特征的总睡眠时间比例与肠道微生物群的变化之间存在密切关联，表明去饱和水平升高与明显的微生物群失调相关（P<0.05）。
与对照组相比，OSA患者表现出的间歇性缺氧可能与肠道微生物群的组成和结构改变有关。我们的结果证明了在未来临床实践中监测缺氧指标的重要性。
