Uric acid, high density lipoprotein cholesterol and their ratio are related to microbial enterotypes and serum metabolites in females with blood stasis constitution

Abstract Background Blood stasis constitution in Traditional Chinese Medicine (TCM) is believed to render individuals more susceptible to metabolic diseases. However, the biological underpinnings of this constitutional imbalance remain unclear. Methods This study explored the association between blood stasis constitution, serum metabolic markers including uric acid (UA), high-density lipoprotein cholesterol (HDLC) and their ratio (UHR), gut microbiota and serum metabolites. Clinical data, fecal and serum samples were collected from 24 individuals with blood stasis constitution and 80 with balanced constitution among healthy subjects from Guangdong. Gut microbiota composition analysis and serum metabolomics analysis were performed. Results Females with blood stasis constitution had higher UA levels, lower HDLC levels, and higher UHR in serum, suggesting a higher risk of metabolic abnormalities. Analysis of the gut microbiome revealed two distinct enterotypes dominated by Bacteroides or Prevotella. Intriguingly, blood stasis subjects were disproportionately clustered within the Bacteroides-rich enterotype. Metabolomics analysis identified subtle alterations between groups, including lower phenylalanine and higher trimethylaminoacetone levels in blood stasis. Several differential metabolites displayed correlations with HDLC, UA, or UHR, unveiling potential new markers of metabolic dysregulation. Conclusions Our findings elucidate the intricate interplay between host constitution, gut microbiota, and serum metabolites. The concept of blood stasis offers a unique perspective to identify subtle alterations in microbiome composition and metabolic pathways, potentially signaling underlying metabolic vulnerability, even in the presence of ostensibly healthy profiles. Continued investigation of this TCM principle may reveal critical insights into the early biological processes that foreshadow metabolic deterioration.