Fecal-associated microbiome differences between traditional Chinese medicine qi-deficiency and balanced constitutions

Abstract

Objective: To explore the structural and functional characteristics of the fecal-associated microbiome (FAM) in a traditional Chinese medicine (TCM) qi-deficiency constitution (QDC) by comparing with balanced constitution (BC) and screen the related biomarkers. Methods: In this cross-sectional study, the TCM constitutions of subjects were determined based on published the Classification and Determination of constitution in TCM and further confirmed by a TCM clinician. Clinical characteristics were recorded, and fecal samples were collected for 16S rDNA sequencing using the Illumina Miseq platform. The FAM structure was described using alpha-diversity indexes, beta-diversity indexes, and the relative abundances of the dominant taxa. Differences in the FAM distribution and function were analyzed with a Wilcoxon rank-sum test, MetagenomeSeq, and LEfSe analysis, after which a receiver operating characteristic curve based on the specific operational taxonomic units (OTUs) was constructed to calculate the area under the curve. Results: Our study population was composed of 22 BCs and 9 QDCs. There were no significant differences between the two groups in the distribution of clinical characteristics or alpha-diversity indexes, except for the sweets preference and blood glucose level. In principal coordinate analysis and partial least squares discriminant analysis, the bacterial communities in the BC group samples and QDC group samples clustered separately. Notably, there were 214 OTUs significantly distributed between groups in the MetagenomeSeq analysis, 200 OTUs identified by the Wilcoxon rank-sum test, and 6 OTUs found by the LEfSe analysis. Predicted function analysis revealed that six metabolic pathways were distinctly distributed between the two groups. The area under the curve for the receiver operating characteristic curve based on the four specific OTUs was 0.88. Conclusion: Unique FAM structural and related functional characteristics are displayed in individuals with a QDC, and four specific OTUs could be used as QDC biomarkers to assist in clinical diagnosis.

Keywords

• Fecal-associated microbiome
• Traditional Chinese medicine constitution
• Qi-deficiency constitution
• Balanced constitution
• Biomarkers