Journal of Traditional Chinese Medicine ›› 2025, Vol. 45 ›› Issue (1): 140-151.DOI: 10.19852/j.cnki.jtcm.2025.01.013
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Gut microbial characteristics of the damp-heat constitution: a population-based multicenter cross-sectional study
LI Tianxing1,2, ZHU Linghui1,2, WANG Xueke3, TANG Jun4, YANG Lingling5, PANG Guoming6, LI Huang7, WANG Liying8, DONG Yang1,2, ZHAO Shipeng9, LI Yingshuai2, LI Lingru2(
)
- 1 Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
2 National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
3 the Second Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou 450046, China
4 Department of Hepatobiliary Spleen and Stomach, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China
5 Henna Province Hospital of Traditional Chinese Medicine, Henan 450002, China
6 Department of Endocrinology, Kaifeng Hospital of traditional Chinese Medicine, Kaifeng 475001, China
7 State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
8 College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
9 Graduate School of China Academy of Chinese Medical Sciences, Beijing 100700, China
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Received:2023-12-22Accepted:2024-03-11Online:2025-02-15Published:2025-01-10 -
Contact:Prof. LI Lingru, National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.Lilingru912@163.com Telephone: +86-13718230332 -
Supported by:National Nonprofit Institute Research Grant for the Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences: Mechanism of Regulating Phlegm-Dampness Constitution to Prevent Metabolic Diseases based on Gut Microbiota-host DNA Methylation(YZ-202151)
Cite this article
LI Tianxing, ZHU Linghui, WANG Xueke, TANG Jun, YANG Lingling, PANG Guoming, LI Huang, WANG Liying, DONG Yang, ZHAO Shipeng, LI Yingshuai, LI Lingru. Gut microbial characteristics of the damp-heat constitution: a population-based multicenter cross-sectional study[J]. Journal of Traditional Chinese Medicine, 2025, 45(1): 140-151.
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Figure 1 Flow diagram of the enrollment process of the DHC and BC volunteers TCMC: Traditional Chinese Medicine constitution; BC: balanced constitution; DHC: damp-heat constitution.
Figure 1 Flow diagram of the enrollment process of the DHC and BC volunteers TCMC: Traditional Chinese Medicine constitution; BC: balanced constitution; DHC: damp-heat constitution.
Table 1 Demographic information of the participants
| Characteristic | BC (n = 146) | DHC (n = 103) | P valuea |
|---|---|---|---|
| Age (years) | 30.0±6.6 | 29.4±5.0 | 0.818 |
| Sex (n) | 0.327 | ||
| Male | 52 | 43 | / |
| Female | 94 | 60 | / |
| Weight (kg) | 60.1±10.7 | 62.1±11.7 | 0.096 |
| Height (cm) | 165.7±7.8 | 167.2±7.4 | 0.172 |
| BMI (kg/m2) | 21.7±2.4 | 22.1±3.1 | 0.442 |
Table 1 Demographic information of the participants
| Characteristic | BC (n = 146) | DHC (n = 103) | P valuea |
|---|---|---|---|
| Age (years) | 30.0±6.6 | 29.4±5.0 | 0.818 |
| Sex (n) | 0.327 | ||
| Male | 52 | 43 | / |
| Female | 94 | 60 | / |
| Weight (kg) | 60.1±10.7 | 62.1±11.7 | 0.096 |
| Height (cm) | 165.7±7.8 | 167.2±7.4 | 0.172 |
| BMI (kg/m2) | 21.7±2.4 | 22.1±3.1 | 0.442 |
Figure 2 Gut microbiome diversity and structure analysis A: the observed ASVs differences between the DHC and BC groups; B: Shannon index indicating diversity differences between the DHC and BC groups; C: PCoA with Bray-Curtis distance showing that the overall microbial composition of DHC deviated from the BC (P = 0.006, permutational multivariate analysis of variance (PERMANOVA) by Adonis); D: PCoA with unweighted UniFrac distance shows that the overall microbial composition of DHC deviated from the BC (P = 0.034, PERMANOVAR by Adonis). BC group (red dots); DHC group (blue dots) represent individual samples. E: associated factors with gut microbiome in the BC and DHC cohort. Red bars indicate statistical significance (P < 0.05); F: associated factors with gut microbiome in the BC cohort. Red bars indicate statistical significance (P < 0.05); G: associated factors with gut microbiome in the DHC cohort. Red bars indicate statistical significance (P < 0.05); H: PCoA analysis of BC in different regions based on Bray-Curtis distances; I: PCoA analysis of DHC in different regions based on Bray-Curtis distances. Compared with the DHC group, aP < 0.001; compared with the BC group, bP < 0.001, Wilcoxon rank-sum test. BC: balanced constitution group; DHC: damp-heat constitution group; GZ: Guanzghou, China; HZ: Huangzhou, China; ZZ: Zhengzhou, China; KF: Kaifeng, China; BJ: Beijing, China.
Figure 2 Gut microbiome diversity and structure analysis A: the observed ASVs differences between the DHC and BC groups; B: Shannon index indicating diversity differences between the DHC and BC groups; C: PCoA with Bray-Curtis distance showing that the overall microbial composition of DHC deviated from the BC (P = 0.006, permutational multivariate analysis of variance (PERMANOVA) by Adonis); D: PCoA with unweighted UniFrac distance shows that the overall microbial composition of DHC deviated from the BC (P = 0.034, PERMANOVAR by Adonis). BC group (red dots); DHC group (blue dots) represent individual samples. E: associated factors with gut microbiome in the BC and DHC cohort. Red bars indicate statistical significance (P < 0.05); F: associated factors with gut microbiome in the BC cohort. Red bars indicate statistical significance (P < 0.05); G: associated factors with gut microbiome in the DHC cohort. Red bars indicate statistical significance (P < 0.05); H: PCoA analysis of BC in different regions based on Bray-Curtis distances; I: PCoA analysis of DHC in different regions based on Bray-Curtis distances. Compared with the DHC group, aP < 0.001; compared with the BC group, bP < 0.001, Wilcoxon rank-sum test. BC: balanced constitution group; DHC: damp-heat constitution group; GZ: Guanzghou, China; HZ: Huangzhou, China; ZZ: Zhengzhou, China; KF: Kaifeng, China; BJ: Beijing, China.
Figure 3 Differences in bacterial species between DHC and BC A: bar plot of bacterial phylum distribution in each group. n = 146 for the BC group and n = 103 for the DHC group; B: component proportion data of bacterial phylum in each group. n = 146 for the BC group and n = 103 for the DHC group; C: the ratio of Firmicutes/Bacteroidetes of DHC showed significantly lower than that of BC; D: genera were strikingly different between DHC and BC. Compared with the DHC group, aP < 0.001; compared with the BC group, bP < 0.001, Wilcoxon rank-sum test. Relative abundance of the significantly different genera across groups at the criteria of P <0.05 (Wilcoxon rank-sum test) and adjust P < 0.2 (FDR) (display of genera with relative abundance greater than 0.1%). BC: balanced constitution; DHC: damp-heat constitution. Boxes represent the interquartile ranges; lines inside the boxes denote medians. Three genera colored in red according to FDR adjusted P < 0.05.
Figure 3 Differences in bacterial species between DHC and BC A: bar plot of bacterial phylum distribution in each group. n = 146 for the BC group and n = 103 for the DHC group; B: component proportion data of bacterial phylum in each group. n = 146 for the BC group and n = 103 for the DHC group; C: the ratio of Firmicutes/Bacteroidetes of DHC showed significantly lower than that of BC; D: genera were strikingly different between DHC and BC. Compared with the DHC group, aP < 0.001; compared with the BC group, bP < 0.001, Wilcoxon rank-sum test. Relative abundance of the significantly different genera across groups at the criteria of P <0.05 (Wilcoxon rank-sum test) and adjust P < 0.2 (FDR) (display of genera with relative abundance greater than 0.1%). BC: balanced constitution; DHC: damp-heat constitution. Boxes represent the interquartile ranges; lines inside the boxes denote medians. Three genera colored in red according to FDR adjusted P < 0.05.
Figure 4 Diagnostic outcomes are shown via ROC curves for DHC and BC A: random Forest models constructed using explanatory variables of ASVs; B: detailed explanatory variables of the random forest model based on ASVs. The lengths of the bars in the histogram represent the mean decrease accuracy, which indicates the importance of the ASV for classification; C: random Forest models constructed using explanatory variables of species; D: detailed explanatory variables of the random forest model based on species. The lengths of the bars in the histogram represent the mean decrease accuracy, which indicates the importance of the species for classification; E: ROC of the cross-validated random forest classifier using the most important explanatory variables in the validation cohort. BC: balanced constitution; DHC: damp-heat constitution; ROC: receiver operating characteristic; ASV: amplicon sequence variant.
Figure 4 Diagnostic outcomes are shown via ROC curves for DHC and BC A: random Forest models constructed using explanatory variables of ASVs; B: detailed explanatory variables of the random forest model based on ASVs. The lengths of the bars in the histogram represent the mean decrease accuracy, which indicates the importance of the ASV for classification; C: random Forest models constructed using explanatory variables of species; D: detailed explanatory variables of the random forest model based on species. The lengths of the bars in the histogram represent the mean decrease accuracy, which indicates the importance of the species for classification; E: ROC of the cross-validated random forest classifier using the most important explanatory variables in the validation cohort. BC: balanced constitution; DHC: damp-heat constitution; ROC: receiver operating characteristic; ASV: amplicon sequence variant.
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