Abstract
Background
Osteoporosis (OP) has become a major public health issue, threatening the bone health of middle-aged and elderly people from all around the world. Changes in the gut microbiota (GM) are correlated with the maintenance of bone mass and bone quality. However, research results in this field remain highly controversial, and no systematic review or meta-analysis of the relationship between GM and OP has been conducted. This paper addresses this shortcoming, focusing on the difference in the GM abundance between OP patients and healthy controls based on previous 16S ribosomal RNA (rRNA) gene sequencing results, in order to provide new clinical reference information for future customized prevention and treatment options of OP.
Methods
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we comprehensively searched the databases of PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI). In addition, we applied the R programming language version 4.0.3 and Stata 15.1 software for data analysis. We also implemented the Newcastle-Ottawa Scale (NOS), funnel plot analysis, sensitivity analysis, Egger’s test, and Begg’s test to assess the risk of bias.
Results
This research ultimately considered 12 studies, which included the fecal GM data of 2033 people (604 with OP and 1429 healthy controls). In the included research papers, it was observed that the relative abundance of Lactobacillus and Ruminococcus increased in the OP group, while the relative abundance for Bacteroides of Bacteroidetes increased (except for Ireland). Meanwhile, Firmicutes, Blautia, Alistipes, Megamonas, and Anaerostipes showed reduced relative abundance in Chinese studies. In the linear discriminant analysis Effect Size (LEfSe) analysis, certain bacteria showed statistically significant results consistently across different studies.
Conclusions
This observational meta-analysis revealed that changes in the GM were correlated with OP, and variations in some advantageous GM might involve regional differences.
概要
骨质疏松症(osteoporosis,OP)已成为严重威胁全球中老年人骨健康的重大公共卫生问题。肠道菌群(gut microbiota,GM)的改变与维持骨量和骨质量有关。然而,相关研究结果仍存在很大争议,目前尚没有研究对肠道菌群和骨质疏松间关系进行过系统评价和荟萃分析。本研究通过对骨质疏松症患者和健康人群之间肠道菌群差异的既往16S rRNA基因测序结果进行系统评价和荟萃分析,以期为未来个体化预防和治疗骨质疏松症提供新的临床参考。这项观察性的荟萃分析显示,肠道菌群的改变与骨质疏松症之间存在关联,并且一些优势菌群的变化可能存在地域差异。
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Acknowledgments
This work was supported by the National Natural Science Foundation of China (No. 81860391), the Guangxi Medical High-level Backbone Talents Training “139” Program Training Project (No. [2020]15), and the Guangxi Hundred Thousand Talents Project (No. [2019]32), China.
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Conceptualization: Gaofeng ZENG and Shaohui ZONG; Methodology: Jieqiong HUANG; Formal analysis: Rui HUANG and Huihua LI; Resources: Yeping SU; Writing — original draft preparation: Rui HUANG and Pan LIU; Writing — review and editing: Rui HUANG, Ruixin MA, and Quan ZHOU; Visualization: Rui HUANG and Yiguang BAI; Project administration: Rui PAN; Funding acquisition: Gaofeng ZENG and Shaohui ZONG. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Rui HUANG, Pan LIU, Yiguang BAI, Jieqiong HUANG, Rui PAN, Huihua LI, Yeping SU, Quan ZHOU, Ruixin MA, Shaohui ZONG, and Gaofeng ZENG declare that they have no conflict of interest.
This article does not contain any studies with human or animal subjects performed by any of the authors.
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Tables S1 and S2; Figs. S1 and S2; Materials and methods
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Huang, R., Liu, P., Bai, Y. et al. Changes in the gut microbiota of osteoporosis patients based on 16S rRNA gene sequencing: a systematic review and meta-analysis. J. Zhejiang Univ. Sci. B 23, 1002–1013 (2022). https://doi.org/10.1631/jzus.B2200344
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DOI: https://doi.org/10.1631/jzus.B2200344