Gut microbiota characteristics in patients with Symptomatic atherosclerotic intracranial arterial stenosis combined with obstructive sleep apnea syndrome
LIAO Shuoxi
YANG Hui
WU Ting
WU Mingxiu
HU Qiongli
BAO Zeyan
TANG Xiaomei
ZHUANG Sidian
DU Haoyong
ZHONG Shuisheng
Abstract：Objective To investigate the characteristics of the gut microbiota in patients with symptomatic intracranial atherosclerotic stenosis(sICAS)complicated with obstructive sleep apnea syndrome(OSAS).Methods From April 2022 to June 2024,clinical data and fecal samples of 109 confirmed sICAS patients hospitalized in the Department of Neurology,Guangdong Sanjiu Brain Hospital were prospectively collected.According to the apnea-hypopnea index(AHI),patients were divided into four groups:non-OSAS group(control group,AHI<5),mild OSAS group(5≤AHI<15),moderate OSAS group(15≤AHI<30),and severe OSAS group(AHI≥30).Total fecal DNA was extracted following standardized procedures.The V3-V4 regions of the 16S rRNA gene were amplified and subjected to Illumina high-throughput sequencing.Bioinformatics analyses,including sequence assembly,quality control,and amplicon sequence variant(ASV/OTU)construction,were performed using QIIME2 and related platforms.α-diversity and β-diversity were calculated,and intergroup differences in gut microbiota were compared.Differential taxa were identified using linear discriminant analysis effect size(LEfSe).Functional metabolic pathway prediction and KEGG annotation were conducted using PICRUSt2.Results A total of 27 patients in the control group and 82 patients in the OSAS groups were included,comprising 30 mild,30 moderate,and 22 severe cases.Compared with the control group,patients in the OSAS groups showed no significant differences in gut microbial α-diversity or β-diversity(P>0.05).Analysis of microbial composition revealed that,relative to controls,OSAS patients exhibited a significant decrease in the relative abundance of the butyrate-producing genus Blautia,while Lactobacillus and Acinetobacter were significantly increased.Functional prediction based on the KEGG database using PICRUSt2 indicated that the D-glutamine and D-glutamate metabolism pathway,D-alanine metabolism pathway,and secondary bile acid biosynthesis pathway were significantly upregulated in OSAS patients.Furthermore,as OSAS severity increased,pathways involved in valine,leucine,and isoleucine biosynthesis,as well as pantothenate and CoA biosynthesis,showed a decreasing trend.Conclusion Patients with sICAS complicated with severe OSAS exhibit gut microbiota dysbiosis and altered metabolic functions.Modulating gut microbiota composition may have potential benefits.
Keywords：obstructive sleep apnea syndromesymptomatic intracranial atherosclerotic stenosisgut microbiotahigh-throughput sequencing
Publication Date：2025-12-20
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：10( 1538-1547 )