中青年脑卒中伴与不伴高同型半胱氨酸血症患者肠道菌群特征的差异及临床意义

doi:10.3969/j.issn.1006-6233.2024.07.025

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Abstract Objective: To investigate the differences in gut microbiota characteristics and clinical significance between middle-aged and young stroke patients with and without hyperhomocysteinemia (Hcy). Methods: A total of 110 middle-aged and young stroke patients were enrolled as the study group from January 2022 to December 2023. According to the presence or absence of hyperhomocysteinemia, they were divided into the hyperhomocysteinemia (Hcy) subgroup and the normal Hcy subgroup. 55 healthy volunteers who underwent physical examination during the same period were selected as the control group. The incidence of gut microbiota dysbiosis, Alpha diversity, and relative abundance of the research group and control group, the research group subgroups were compared. The relationship between gut microbiota and hyperhomocysteinemia, and stroke was analyzed, and the predictive value of gut microbiota for stroke with hyperhomocysteinemia was evaluated. Results: The incidence of gut microbiota dysbiosis was significantly higher in the Hcy group (52.73%) than in the non-Hcy group (18.18%). The Simpson index (417.61±66.51) was higher in the Hcy group than in the non-Hcy group (668.39±91.08), while the Chaol index (0.96±0.06), Shannon index (2.13±0.52) were lower in the Hcy group than in the non-Hcy group (0.90±0.03), (4.67±0.45) (χ²=18.061, t=20.103, 6.985, 30.891, P<0.001). The abundance of Firmicutes was lower in the Hcy group than in the non-Hcy group, while the abundance of Bacteroidetes and Proteobacteria was higher in the Hcy group (P<0.05). The abundance of Bacteroides genus was higher in the Hcy group than in the non-Hcy group, while the abundance of Bifidobacterium genus, Faecalibacterium genus, and Collinsella genus was lower in the Hcy group (P<0.05). The incidence of gut microbiota dysbiosis was significantly higher in the high-Hcy subgroup (80.00%) than in the normal-Hcy subgroup (33.85%). The Simpson index (383.43±53.18) was higher in the high-Hcy subgroup than in the normal-Hcy subgroup (441.27±65.39), while the Chaol index (0.99±0.05), Shannon index (2.02±0.18) were lower in the high-Hcy subgroup than in the normal-Hcy subgroup (0.94±0.03), (2.21±0.25) (χ²=22.725, t=4.913, 6.545, 4.371, P<0.001). The abundance of Firmicutes was lower in the high-Hcy subgroup than in the normal-Hcy subgroup, while the abundance of Bacteroidetes and Proteobacteria was higher in the high-Hcy subgroup (P<0.05). The abundance of Bacteroides genus was higher in the high-Hcy subgroup than in the normal-Hcy subgroup, while the abundance of Bifidobacterium genus, Faecalibacterium genus, and Collinsella genus was lower in the high-Hcy subgroup (P<0.05). Gut microbiota dysbiosis, Simpson index, and high Hcy were positively correlated with stroke and stroke with Hcy, while Chaol index and Shannon index were negatively correlated with stroke and stroke with Hcy (P<0.05). The area under the curve (AUC) of gut microbiota dysbiosis, Simpson index, Chaol index, and Shannon index for predicting stroke with Hcy in middle-aged and young patients was 0.731 (95%CI: 0.638~0.811), 0.809 (95%CI: 0.723~0878), 0.782 (95%CI: 0.693~0.855), and 0.822 (95%CI: 0.738-0.889), respectively. The sensitivity and specificity were 80.00%, 86.67%, 82.22%, and 75.56%, and 66.15%, 69.23%, 61.54%, and 75.38%, respectively. Conclusion: The incidence of intestinal flora imbalance in middle-aged and young stroke patients with hyperHCY is higher, the diversity is decreased, and the abundance is also significantly changed, which can be used as an auxiliary index to predict stroke patients with hyperHcy, and provide a new perspective for clinical practice.

Key words： Young and middle-aged Stroke Hyperhomocysteinemia Intestinal flora characteristics Alpha diversity Relative abundance Predictive value

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	WANG Xueming
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Cite this article:

WANG Xueming,ZHOU TiaoHua,LI LiTing, et al. Differences in Gut Microbiota Characteristics and Clinical Significance between Middle-aged and Young Stroke Patients with and without Hyperhomocysteinemia[J]. HeBei Med, 2024, 30(7): 1191-1197.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.07.025 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I7/1191

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