Yu Ning, Yang Yaotang, Wang Guangyun, Wang Yanhong, Feng Mei, Yang Peilin, Liu Shuang, Wang Rui-Rui, Zhang Lei
School of Public Health, Shanghai Innovation Center of Traditional Chinese Medicine Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Cell Infect Microbiol. 2025 Mar 4;15:1507076. doi: 10.3389/fcimb.2025.1507076. eCollection 2025.
Prehypertension is the preclinical stage of hypertension, which is more likely to develop into hypertension than normal blood pressure. Although the body may experience pathological changes at this stage, there are often no symptoms. Chinese medicine constitution theory is widely used to assess an individual's health and disease status, which provides a new method for disease prevention. The phlegm-dampness constitution (PDC) is the main constitution in prehypertension. Dysbiosis of the intestinal flora is considered to be related to the development of hypertension. However, the characteristics of the intestinal flora in prehypertensive populations with PDCs are still unknown.
16S rRNA gene sequencing of fecal samples was performed in this study, which included 30 prehypertensive subjects with PDCs, 30 nonphlegm-dampness constitution (NPDC) prehypertensive individuals with balanced constitution, and 30 ideal blood pressure subjects with balanced constitution (BC). On the basis of the composition of the intestinal flora, a random forest classifier was constructed to screen the specific bacteria of the prehypertensive PDC population, and the diagnostic efficiency was determined by the area under the curve (AUC).
At the phylum level, the abundance of decreased in the PDC group compared with the NPDC group. was the most important genus at the genus level. Compared with those in the NPDC or BC group, the relative abundances of , , , , and in the PDC group were significantly greater. The random forest analysis results revealed that , , , , and are bacterial genera that significantly differ between the PDC and NPDC groups and greatly contribute to group differentiation. Receiver operating characteristic (ROC) analysis revealed that the AUC range of differential bacteria and its combined diagnostic model ranged from 0.653 (95% CI: 0.511-0.794) to 0.706 (95% CI: 0.573-0.838), suggesting that it is a potential risk marker for phlegm-dampness constitution with prehypertension.
Our study indicates that PDC individuals with prehypertension can be distinguished from NPDC individuals according to their gut microbiome characteristics. Prevention and treatment measures based on these biomarkers may be beneficial in opening new ideas and directions for identifying more aggressive and effective interventions for prehypertensive populations.
高血压前期是高血压的临床前期阶段，相较于正常血压人群，其发展为高血压的可能性更大。尽管在此阶段身体可能会出现病理变化，但通常没有症状。中医体质理论被广泛用于评估个体的健康和疾病状态，为疾病预防提供了一种新方法。痰湿体质是高血压前期的主要体质类型。肠道菌群失调被认为与高血压的发生发展有关。然而，具有痰湿体质的高血压前期人群的肠道菌群特征仍不明确。
本研究对粪便样本进行16S rRNA基因测序，研究对象包括30例具有痰湿体质的高血压前期受试者、30例非痰湿体质（NPDC）且体质平和的高血压前期个体以及30例体质平和的理想血压受试者（BC）。基于肠道菌群的组成构建随机森林分类器，以筛选高血压前期痰湿体质人群的特异性细菌，并通过曲线下面积（AUC）确定诊断效率。
在门水平上，与NPDC组相比，PDC组中[某菌门]的丰度降低。[某菌属]是属水平上最重要的菌属。与NPDC组或BC组相比，PDC组中[某些菌属]的相对丰度显著更高。随机森林分析结果显示，[某些菌属]是PDC组和NPDC组之间存在显著差异且对组间区分贡献较大的细菌属。受试者工作特征（ROC）分析显示，差异细菌及其联合诊断模型的AUC范围为0.653（95%CI：0.511 - 0.794）至0.706（95%CI：0.573 - 0.838），表明其是高血压前期痰湿体质的潜在风险标志物。
我们的研究表明，具有高血压前期的痰湿体质个体可根据其肠道微生物组特征与非痰湿体质个体区分开来。基于这些生物标志物的防治措施可能有助于为识别更积极有效的高血压前期人群干预措施开辟新的思路和方向。
