Supplementary Material for: Specific alterations of Gut microbiota in Chinese patients with Hypertension: A systematic review and meta-analysis

ABSTRACT Background: China has the largest absolute burden of hypertension (HTN) in the world. Gut dysbiosis may be a potentially modifiable risk factor for HTN. However, the characteristics of gut microbiota in Chinese populations with HTN remain to be determined. Methods: We systematically searched for studies comparing the gut microbial in HTN with healthy controls in databases. The cut-off date was December 30, 2021. Semiquantitative analysis and meta-analysis with standardized mean differences of the alteration in gut microbiota were carried out. Results: A total of 16 studies involving 2372 patients with HTN and 849 controls were included, covering 16 Chinese provinces or regions. The present study supports that compared to healthy population, the diversity of patients with HTN is significantly compromised, while richness is overall preserved. To be specific, a significant increase of the Firmicutes(F)/Bacteroidetes(B) ratio is considered as a special parameter of gut microbiota in HTN patients. The increased abundance of phylum Firmicutes, genus Megasphaera, Escherichia_Shigella, and Klebsiella, while the lower abundance of phylum Bacteroidetes, genus Bifidobacterium, Faecalibacterium, Roseburia, and Ruminococcus may be associated with HTN. The gut microbial metabolism in HTN was more abundant in LPS biosynthesis, membrane transport, and steroid degradation. Conclusions: Variation in gut microbial parameters is likely associated with Chinese patients with HTN. Further investigations should distinguish geographical and ethnic characteristics to develop in-depth knowledge of the underlying mechanisms by which gut dysbiosis contributes to HTN.摘要 背景：中国是全球高血压（hypertension, HTN）绝对疾病负担最重的国家。肠道菌群失调可能是高血压潜在的可干预危险因素，但中国高血压人群的肠道菌群特征仍有待明确。 方法：本研究系统检索了数据库中对比高血压患者与健康对照者肠道菌群的相关研究，检索截止日期为2021年12月30日。采用半定量分析及基于标准化均数差的Meta分析（meta-analysis），对肠道菌群的变化进行评估。 结果：最终纳入16项研究，共涉及2372例高血压患者及849名健康对照者，覆盖中国16个省份或地区。本研究证实，与健康人群相比，高血压患者的肠道菌群多样性显著降低，而菌群丰富度整体保持稳定。具体而言，厚壁菌门（Firmicutes）与拟杆菌门（Bacteroidetes）的比值（F/B比值）显著升高，可作为高血压患者肠道菌群的特异性特征参数。厚壁菌门、巨球形菌属（Megasphaera）、埃希氏菌-志贺氏菌属（Escherichia_Shigella）及克雷伯菌属（Klebsiella）的丰度显著升高，而拟杆菌门、双歧杆菌属（Bifidobacterium）、粪杆菌属（Faecalibacterium）、罗斯氏菌属（Roseburia）及瘤胃球菌属（Ruminococcus）的丰度显著降低，上述菌群变化可能与高血压相关。高血压患者的肠道菌群代谢通路在脂多糖（LPS）生物合成、膜转运及类固醇降解方面更为富集。 结论：肠道菌群参数的变化可能与中国高血压患者密切相关。未来研究应区分地域及种族特征，以深入阐明肠道菌群失调参与高血压发病的潜在机制。