Tahmasebi Ali, Beheshti Rasa, Mahmoudi Mohammadsina, Jalilzadeh Mahan, Salehi-Pourmehr Hanieh
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.
Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran; Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Respir Med. 2025 May;241:108077. doi: 10.1016/j.rmed.2025.108077. Epub 2025 Mar 28.
This systematic review investigates gut bacterial diversity and composition in patients with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) and examines how these changes may contribute to cardiovascular complications.
A comprehensive search was conducted in PubMed, Web of Science, and Scopus up to March 2025. After removing duplicates, titles and abstracts were screened by two reviewers, and full texts were assessed for inclusion. Data extraction on study characteristics and outcomes was performed. Methodological quality was evaluated using the Joanna Briggs Institute checklist. α-diversity was assessed using richness and diversity indices, while β-diversity examined community structure differences. Meta-analysis was conducted using standardized mean differences (SMD) and confidence intervals (CIs), and heterogeneity was assessed with the Cochrane I test.
The review included 18 studies (16 adults, 2 pediatrics) examining the gut microbiome in OSAHS. Meta-analysis revealed significant reductions in α-diversity indices (Shannon, Chao1, observed species, ACE) in OSAHS patients, while Simpson's index showed no difference. β-diversity analyses showed distinct gut microbiome differences in OSA. Key differential bacteria included Bacteroides, Proteobacteria, Faecalibacterium, Ruminococcaceae, Megamonas, Oscillibacter, Dialister, Roseburia, and Lachnospira. Study quality was medium to high.
OSAHS is associated with significant gut microbiome alterations, including a reduction in beneficial bacteria and an increase in LPS-producing bacteria, leading to intestinal barrier dysfunction. These changes may contribute to systemic inflammation and elevate the risk of cardiovascular diseases.
本系统评价研究阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的肠道细菌多样性和组成，并探讨这些变化如何导致心血管并发症。
截至2025年3月，在PubMed、科学网和Scopus数据库中进行了全面检索。去除重复文献后，由两名评审员筛选标题和摘要，并评估全文是否纳入。提取了关于研究特征和结果的数据。使用乔安娜·布里格斯研究所的清单评估方法学质量。使用丰富度和多样性指数评估α多样性，而β多样性则检查群落结构差异。使用标准化平均差（SMD）和置信区间（CI）进行荟萃分析，并使用Cochrane I检验评估异质性。
该评价纳入了18项研究（16项针对成人，2项针对儿科），研究了OSAHS患者的肠道微生物群。荟萃分析显示，OSAHS患者的α多样性指数（香农指数、Chao1指数、观察到的物种数、ACE指数）显著降低，而辛普森指数无差异。β多样性分析显示OSA患者的肠道微生物群存在明显差异。关键的差异细菌包括拟杆菌属、变形菌门、粪杆菌属、瘤胃球菌科、巨单胞菌属、颤杆菌属、戴阿李斯特菌属、罗斯氏菌属和毛螺菌属。研究质量为中等至高。
OSAHS与肠道微生物群的显著改变有关，包括有益细菌减少和产LPS细菌增加，导致肠道屏障功能障碍。这些变化可能导致全身炎症，增加心血管疾病的风险。
