Characteristics of Gut Microbiota in Different Regions and Ethnic Minorities of China and Their Associations with Diseases

Characteristics of Gut Microbiota in Different Regions and Ethnic Minorities of China and Their Associations with Diseases | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 24 January 2025 V1 Latest version Share on Characteristics of Gut Microbiota in Different Regions and Ethnic Minorities of China and Their Associations with Diseases Authors : Binbin Xia 0009-0005-7439-0376 , Xinbi , Bo Li , Haoyu Wang , Mengmeng Wang , Yuanqiang Zou [email protected] , Yinglei Miao , and Yang Sun Authors Info & Affiliations https://doi.org/10.22541/au.173772014.40176388/v1 789 views 174 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract The human gut microbiome, an essential component of the human digestive tract, is influenced by various elements including geographical location, ethnic background, dietary patterns, and genetic makeup. Geographical location, in particular, plays a significant role, as different regions in China exhibit distinct and unique bacterial groups. Furthermore, the impact of ethnicity on the composition of the gut microbiota should not be overlooked. In China, with its 56 ethnic subgroups, there exists an ethnic-specific clustering of gut microbiota, which contributes to a diverse range of microbial resources due to the presence of numerous minority groups. The relationship between gut microbiota and various diseases is an increasingly investigated area. Ethnic-specific gut microbiota can result in differences in disease incidence, and individuals from different ethnic groups may display variations in their gut microbiota when experiencing the same disease. The objective of this study is to present a comprehensive overview of the distinctive gut microbiome profiles across various regions and ethnic groups within China. This research highlights the unique characteristics of the gut microbiome among these minority populations and investigates the correlations between specific gut microbes and associated health conditions, a subject that remains underexplored in the current literature. This information will provide a basis for personalized medicine and the development of disease diagnostic models utilizing gut microbiota as biomarkers, thereby enabling more effective treatment plans and health management strategies. Introduction The gut microbiome encompasses an extensive array of microbial life, such as bacteria, fungi, archaea, and viruses [1]. It represents the largest and most diverse community of species within the human body[2]. The gastrointestinal tract is home to countless microbial species, with the number of cells within the gut microbiota ranging from 10 13 to 10 14 , which is ten times the number of human cells in the body [3]. Furthermore, the genomic content of the gut microbiota is 100 times greater than that of the human genome[4]. The gut microbiota is primarily composed of the bacterial phyla Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria[5]. These numerous gut microorganisms are considered potential key factors for health[6,7]. These microorganisms perform essential biological functions within the gastrointestinal tract, including facilitating digestion and the uptake of nutrients[8],preserving the integrity of the intestinal mucosal barrier[9],combating the encroachment of harmful microorganisms[10],and modulating the host’s immune response[11]. They also establish a symbiotic relationship with the human body, characterized by mutual influence and interdependence. However, alterations in the microbial composition can potentially impair these protective mechanisms, a phenomenon referred to as dysbiosis, which may subsequently lead to a range of neurological disorders, metabolic diseases, and gastrointestinal conditions[12]. In various human gastrointestinal tracts, there are distinct dominant bacterial communities. These microbial populations are categorized into three unique ”enterotypes,” differentiated by differences observed at the genus level: Bacteroides -dominated, Prevotella -dominated, and Ruminococcus -dominated enterotypes[13]. Further research suggests that the distinctions between different enterotypes become less clear as more samples are collected, indicating that enterotyping primarily relies on classification models[14–19]. Over the past few decades, significant scholarly efforts have been dedicated to the comprehensive investigation of the human microbiome, encompassing its constituent elements[20]. However, it is noteworthy that most current research on gut microbiota has been conducted outside of China, while studies focused on the gut microbiome within China’s ethnic minority populations remain comparatively limited. Given the vastness of China, its population structure is predominantly composed of the Han majority alongside 55 ethnic minorities residing across various regions. These ethnic minorities have developed unique lifestyles, cultures, and genetic characteristics[21]. There exists a strong correlation between these variations and the progression of the gut microbiome. The varied ethnic backgrounds within the Chinese population contribute to the diversity, variability, and shared characteristics of gut microbiota lineages[22]. Consequently, comprehending the types and compositional traits of gut microbiota in Chinese ethnic minorities holds great significance for personalized medical diagnosis and treatment. Moreover, genetic variations linked to geographical origins can potentially impact the host’s selection and metabolism of microorganisms, consequently affecting the development of the gut microbiome. Gaining knowledge about the composition of the gut microbiota across various geographic regions and ethnic communities can offer valuable insights for future research and the application of gut microbiota biomarkers. 1.GEOGRAPHIC ORIGIN AND GUT MICROBIOTA 1.1 The relationship between geographic origin and gut microbiota An individual’s gut microbiome profile is shaped by a multitude of elements, including their geographical background, way of living, genetic makeup, nutritional habits, pharmaceutical intake, and ecological factors[23–26]. Among the various determinants, the region of origin substantially contributes to the formation of an individual’s gut microbiome. Differences in dietary habits, living conditions, and other regional aspects lead residents of different areas to consume unique nutrients and microorganisms, resulting in variations in the composition of their gut microbiota. It is essential to comprehend these regional variations in order to develop personalized strategies for maintaining and enhancing gut health. Previously, a large-scale cohort study collected fecal samples from 32 different countries and regions and conducted metagenomic analyses, demonstrating that the composition of gut microbiota shows significant geographic specificity[27]. Furthermore, healthy adults in regions outside of China, such as the Venezuelan Amazon, rural Malawi, and urban areas of the United States, also display distinct gut microbiota characteristics[28]. They study observed that the variations in gut microbiota composition among individuals from different countries are strongly associated with their geographic location[29]. Diversity in the gut microbiome of children from several Asian nations, including China, Japan, Thailand, and Indonesia, has uncovered two separate, enterotype-like groupings. These groupings are primarily characterized by the prevalence of Prevotella (P-type) or a combination of Bifidobacterium and Bacteroides (BB-type). The majority of children in China and Japan predominantly exhibited the BB-type, while the majority of children in Indonesia and Thailand primarily displayed the P-type. This differentiation in gut microbiota composition highlights the influence of regional factors on microbial communities in children from these countries[30]. Neverthe less, studies examining the link between geographical influences and the gut microbiome have mainly concentrated on individuals residing in Europe, the Americas, and Africa. There is relatively limited data available on this relationship within the Chinese population, which constitutes the largest demographic group in Asia. To investigate the feasibility of disease diagnostic models based on gut microbiota characteristics, Yan and colleagues conducted an analysis of the gut microbiota of over 7,000 residents from 14 regions in Guangdong Province, China. The study discovered that geographic location exhibited the strongest correlation with microbiota differences at the phenotypic level, suggesting that disease prediction models developed in one region cannot be generalized to other regions[31]. Additionally, a longitudinal study carried out in Beijing demonstrated that while the composition of core gut genera fluctuates over time, the core genus Clostridium remains consistently present[32]. Moreover, the gut microbiota structure of ethnic minorities and Han Chinese individuals residing in the same area is more similar than that of individuals of the same ethnicity living in different locations[33]. In summary, geographical location is a significant factor influencing the variations in gut microbiota, which has substantial implications for the development of disease diagnostic models based on gut microbiota characteristics. Furthermore, these findings indicate that the complexity of geographical and ethnic factors should be considered when developing disease prediction models. 1.2 Characteristics of Gut Microbiota in Different Regions of China The makeup and organization of the gut microbiome among individuals with varying regional origins, genetic lineages, and ways of living display considerable variation[34,35]. As sequencing techniques continue to evolve, there has been a growing number of extensive research projects focusing on the gut microbiome within the Chinese demographic. These studies have revealed significant variations in the composition of the gut microbiome composition among individuals from various provinces across China. In recent times, scientists have sought to elucidate the connections among the human gut microbiome, blood metabolites, and overall health. Enrolling 3,224 participants from diverse provinces, the investigation employed a multivariable linear regression model known as MaAsLin to assess the microbiome’s genus-level composition across 15 distinct provincial cohorts. In every province, there was a prevalent genus considered characteristic. For instance, Methanobrevibacter , Halococcus , and Clostridium were found to be particularly abundant in Heilongjiang, Liaoning, and Jiangxi provinces, respectively. On the other hand, Holdemania , Bacillus , and Enhydrobacter were the dominant genera specific to Guangxi, Guangdong, and Zhejiang provinces[36]. Additionally, Henan and Jiangxi provinces shared nine core genera, including Bacteroides and Prevotella [22]. To assess whether regional variations impose limitations on the establishment of reference ranges for healthy gut microbiomes and disease diagnostic models, it has been observed that individuals residing in Guangdong Province, China, exhibit a high abundance of the phylum Proteobacteria in their gut microbiome composition. Additionally, research encompassing over 2,000 well volunteers in Beijing has discovered that the structure and metabolic activities within their gut microbiome correlate with their age and sex, featuring a notable prevalence of the Bacteroidetes phylum and the Prevotella genus[37]. An analysis comparing the gut microbiomes of individuals from Yunnan Province with those from the Hong Kong Special Administrative Region discovered a notably higher presence of Actinobacteria among Hong Kong participants. These results indicate that regional differences substantially affect the makeup of the human gut microbiome[38]. Additionally, 16S rRNA sequencing technology was employed to analyze the gut microbiota of healthy individuals in Shanxi Province. The results indicated that at the genus level, the gut microbiota could be categorized into two major communities, with Bacteroides and Prevotella being the most prevalent[39]. Figure 1 summarizes the dominant bacterial genera in the gut microbiota across different regions of various provinces in China. Fig 1. The dominant bacteria in different regions of China. This figure summarizes the dominant bacterial genera in the gut microbiota of residents from different provinces in China. To conclude, numerous accounts and a growing body of research have focused on the microbial diversity within the gut microbiome across different regions and provinces throughout China. However, a significant portion of these studies concentrate on a particular province or a small subset of the population, which imposes certain limitations on the research findings. Hence, additional research is essential to delve into the microbial makeup within the gut microbiome across a broad spectrum of healthy subjects from China’s myriad ethnicities, geographical locales, and both urban and rural settings. Telegram @manmax90 buy cocaine in London 2. ETHNIC MINORITIES AND GUT MICROBIOTA China’s population accounts for approximately 20% of the global population, with ethnic minorities comprising 8% of China’s total population. Despite being a small proportion of the overall population, these ethnic minorities are concentrated and hold significant influence in various regions of China. These minority groups have developed distinct lifestyles, dietary habits, cultures, and genetic characteristics[21]. Furthermore, A strong correlation is evident between the gut microbiome and these elements[40,41]. Additionally, some of these ethnic groups possess their own unique traditional medicine practices, which differ from traditional Chinese medicine in terms of both application and theory. Notable examples include the Dai and Miao ethnic groups[42]. Ethnic medicine refers to the practice of traditional medicine that combines the medical concepts and real-world experiences of ethnic minorities[43]. The diversity and function of the gut microbiome are significantly influenced by ethnicity [44]. As a result, the differences in microbiota structure among individuals from various ethnic groups are a key focus issues in current gut microbiota research[45]. In a multi-ethnic cohort study, it was found that the gut microbiota diversity of individuals with similar health conditions varies significantly among different ethnic groups, including South Asian Surinamese, Ghanaians, Moroccans, Dutch, and Turks[46–48]. Keohane et al. utilized metagenomic techniques to analyze the diversity, changes in species abundance, and interactions within the microbial network in the gut microbiota of different ethnic groups. They found that ethnicity influences the diversity of the gut microbiota and that the tightness of network interactions between species varies among different ethnic groups[49]. 2.1 Characteristics of Gut Microbiota in Different Ethnic Groups Currently, research focusing on the gut microbiota of ethnic minority populations in China is gradually emerging. Each ethnic group has developed its own distinct dietary habits, culture, and lifestyle. The Bai ethnic minority One study focused on the gut microbiota diversity of Bai adults, specifically examining 43 rural Bai residents from the Dali Bai Autonomous Prefecture in Yunnan Province, China. The study revealed that the Bai population in this region exhibits a high abundance of Lactobacillus and Bifidobacterium , which may be significantly associated with the frequent consumption of traditional dairy products, such as ”rushan,” by the local Bai residents[50]. It is worth noting that Bifidobacterium and Lactobacillus are commonly utilized in the development of probiotic products[51]. Lactobacillus has the capability to metabolize carbohydrates into lactic acid, thereby maintaining the balance of the gut microbiota and promoting a healthy immune system. Additionally, it exhibits antibacterial and antiviral properties[52]. On the other hand, Bifidobacterium can regulate the gut micro-ecological environment and potentially contribute to weight loss[53,54]. These findings suggest that the high prevalence of probiotics in the gut microbiota of the Bai ethnic group warrants further investigation for potential applications. Such uses encompass the implementation of fecal microbiota transfer (FMT) for managing inflammatory bowel conditions stemming from an imbalanced gut microbiome, alongside the creation of probiotic supplements. This line of inquiry may lay the groundwork for innovative treatment approaches and marketable probiotic blends tailored to the distinctive microbial profiles of the Bai ethnic group[55]. The Tibetan ethnic minority The Tibetan ethnic group is primarily distributed in the Qinghai-Tibet Plateau region, which is characterized by strong ultraviolet radiation, low atmospheric pressure, low oxygen levels, and cold temperatures[56].They primarily rely on animal husbandry for their livelihood, with a diet that mainly consists of meat and dairy products. Their daily beverages include tea, yak butter tea, and salted tea[57,58]. As a result, the gut microbiome and its functions of Tibetan residents exhibit distinct ethnic and regional characteristics. Additionally, the Tibetan population possesses genes (EPAS1, EGLN1, and PPARA) that enable better adaptation to the high-altitude climate[59]. Furthermore, the gut microbiome of the Tibetan population is composed of diverse bacterial strains known for their ability to generate short-chain fatty acids. These acids are believed to boost metabolic energy and preserve the equilibrium of the gut microbiome[60]. Research comparing the gut microbiomes of native Tibetans and Han Chinese uncovered significant disparities. In particular, the gut microbiome of Tibetans is marked by an elevated presence of Prevotella and is abundant in butyrate-producing bacteria[61]. Similar characteristics have also been observed in studies on the gut microbiota of Tibetan children[62]. These findings suggest that the unique microbial compositions in Tibetans may be influenced by their distinct lifestyles, diets, and environmental conditions. The Mongolian ethnic minority The Mongolian ethnicity traces its roots back to clans situated in the northern regions of China in the 7th century[63]. The customary diet of Mongolians is marked by a regular and significant intake of cultured milk products, beef, and spirits[64]. Consequently, the prevalence of Collinsella is strongly linked to the substantial consumption of protein-rich diets among Mongolians[65]. A study that recruited Mongolian volunteers and provided them with a high-carbohydrate diet found that the gut microbiota diversity of the volunteers significantly decreased, and the composition of the microbiota also changed[66]. The distinctive makeup of the Mongolian gut microbiome can be attributed to the interplay of environmental, dietary, and genetic factors. Bacterial species from the genera Faecalibacterium , Ruminococcus , Subdoligranulum , and Enterococcus are recognized as characteristic elements within the Mongolian gut microbiota[67]. The Yao ethnic minority The Yao ethnic group primarily resides in the southern regions of China[68]. Numbering around 3 million individuals, the Yao ethnicity is characterized by a distinct genetic heritage and way of life[69,70]. Research comparing the gut microbiome of the Yao ethnicity revealed distinctive features of their gut microbiota through an examination of links between dietary practices, lifestyle factors, biomarkers, and gut microbial profiles. Findings indicated that the Yao had a comparatively increased presence of Megamonas in fecal matter, potentially linked to their substantial consumption of soy in their routine diet. Moreover, an elevated prevalence of Bacteroides was noted[71]. Since soy products can increase the production of short-chain fatty acids, which aid in improving blood lipid levels[72], it has been established that this is beneficial in reducing the incidence of cardiovascular diseases[73]. Consequently, the research has identified a beneficial link between the consumption of soy and higher levels of Megamonas , which could imply that Megamonas possesses probiotic properties. The Li ethnic minority The Li ethnic group is one of the major ethnic minorities in Hainan Province, China, and has a long history of development spanning thousands of years. The diet of the Li population mainly consists of a wide variety of plant-based foods and seafood, which is similar to the Mediterranean diet. Research on the composition of the gut microbiota in the Li population has shown that Prevotella is a dominant genus, accounting for approximately 49.38% of the total gut microbiota. These findings emphasize the significant presence of Prevotella in the gut microbiome of the Li population, which is likely influenced by their dietary habits. Additionally, Megasphaera , which is relatively abundant, is a distinct genus in the gut of the Li people. This genus is either present in low amounts or absent in the gut microbiota of other ethnic groups[74]. Telegram @manmax90 buy cocaine in London The Hezhe ethnic minority The Hezhe ethnic group primarily resides in the Jiamusi region of northeastern China. They are a distinct northern hunting and fishing ethnic group with a dietary tradition that includes the consumption of raw fish[75]. A study analyzing the gut bacterial communities of healthy Hezhe and Han populations discovered that the Hezhe population has a greater diversity of gut microbiota compared to the Han population in the same region. The dominant genus in the Hezhe population was identified as Gemmiger , which may be attributed to their unique dietary habits[76]. Research has confirmed that the genus Gemmiger potentially plays a role in bile acid dehydroxylation and can produce short-chain fatty acids such as butyrate and lactate, which aid in food digestion[77]. Furthermore, there are certain ethnic groups that have received limited research attention regarding their gut microbiota. For instance, Succinivibrio has been found to be relatively abundant in the gut microbiome of Uyghur children[78]. Ruminococcaceae , Lachnospiraceae , and Enterobacteriaceae are the dominant bacterial families in the gut microbiota of healthy Uyghur and Kazakh adults[79]. Additionally, unique strains such as Parabacteroides goldsteinii and Bifidobacterium animalis have been identified in the rural Zhuang population[80]. The gut microbiota of healthy Yi individuals exhibits a clustering pattern, with Prevotella , Faecalibacterium , and Bacteroides being the dominant bacterial genera[81]. This indicates that the unique dietary habits and distinct genetic backgrounds of ethnic minorities have the potential to influence the composition of the gut microbiota. In the gut mycobiome and archaeome, ethnic-specific microbial compositions can also be observed. Sun et al. conducted a population study involving 818 healthy participants from six ethnic groups in Yunnan Province, China (Han, Tibetan, Miao, Bai, Dai, and Hani). From the perspective of the mycobiome, they found significant differences in the gut fungal communities among the six ethnic groups. Specifically, Debaryomyces hansenii and Fusarium graminearum were found to be enriched in the Hani population [36]. Archaea, which are increasingly recognized as a key component of the gut microbiome, also exhibit ethnic-specific characteristics [80]. Similarly, there is significant variability in the archaeal communities among different ethnic minorities [81]. The characteristics of the gut microbiome among members of different ethnic groups in China are summarized in Figure 2. Fig 2. The characteristics of gut microbiota in different ethnic minority populations in China. This figure illustrates the dominant and unique bacterial genera in the gut microbiota of ethnic minorities across different studies. Telegram @manmax90 buy cocaine in London 3. THE RELATIONSHIP BETWEEN GUT MICROBIOTA AND DISEASES IN ETHNIC MINORITY POPULATIONS Current investigations exploring the link between gut microbiomes and illness among China’s ethnic minorities are swiftly progressing. Changes in the composition of the gut microbiota can exert unique effects on the host organism[82]. These microbial changes are strongly associated with a range of digestive and metabolic diseases, including inflammatory bowel disease (IBD)[83], Type II diabetes[84], cardiovascular diseases[85,86], neurological disorders[87], gastric cancer[88], obesity[89]. Consequently, the gut microbiota is often described as a “microbial organ”due to its profound influence on human health [90]. The unique composition of the gut microbiota in ethnic minority populations from various regions is closely linked to the development and progression of specific diseases. Fig 3. The association between gut microbiota and diseases. The diagram depicts the relationship linking the gut microbiome to a range of diseases. By Figdraw. 3.1 The Relationship Between Gut Microbiota and Digestive Diseases in Ethnic Minority Populations Research on the connection between gut microbiota and digestive diseases in ethnic minority populations is gaining traction due to the essential role of the gut microbiome in digestive tract metabolism. For example, ulcerative colitis (UC), a chronic nonspecific inflammatory bowel disease, has been increasingly common in China. The colonic gut microbiota and its metabolites are crucial in the pathogenesis of UC[91,92]. Previous studies have indicated that the positive rate of anti-neutrophil cytoplasmic antibodies (ANCA) in Han UC patients is significantly lower than in Uyghur UC patients ( P =0.026). Additionally, in some Uyghur UC patients, the ANCA positive rate correlates with a higher frequency of HLA-DRB1, while the gene frequency of HLA-DRB1*08 is lower compared to the control group ( P =0.012, odds ratio 0.12, 95% confidence interval (CI) 0.02-0.91)[93,94]. These findings underscore the importance of understanding the genetic and microbial factors that contribute to UC in different ethnic groups. Therefore, ethnic differences in ulcerative colitis (UC) are apparent not only at the genetic level but also in the gut microbiota composition. Researchers led by Liu utilized next-generation sequencing methods to assess the gut microbiome composition in Uyghur and Han individuals afflicted with UC, in a quantitative manner. The study revealed that the abundances of Burkholderia , Caballeronia , and Paraburkholderia were higher in the Uyghur group, whereas Faecalibacterium , Bifidobacterium , and Blautia were more abundant in the Han group[95]. These findings highlight the differences in gut microbiota among ethnic minorities under disease conditions. However, another quantitative analysis of the gut microbiota in Uyghur and Han populations with UC found no significant differences in the abundances of Bacteroides , Fusobacterium , Clostridium , Bifidobacterium , and Faecalibacterium [96]. This suggests that ethnic-related differences in gut microbiota in the context of UC are limited to specific bacterial genera. Therefore, further research is needed to explore the characteristics of gut microbiota UC across different ethnic groups. Currently, there is limited research on how ethnic ancestry affects the gut microbiota and clinical manifestations in patients with irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder marked by psychosomatic symptoms such as abdominal pain, bloating, and constipation[97]. Dysbiosis of the gut microbiota significantly contributes to the onset and symptom development of IBS[98,99]. Recently, researchers compared the gut microbiota characteristics between Tibetan and Han IBS patients. The study found that the proportion of Bacteroides was significantly lower in the Han group compared to the Tibetan group, while the Firmicutes/Bacteroidetes (F/B) ratio was notably lower in the Tibetan group than in the Han group. Interestingly, Tibetan IBS patients were more likely to experience bloating than Han patients (17.41% vs. 9.09%, P <0.001). These findings suggest that ethnic differences may influence the gut microbiota composition and clinical symptoms in IBS patients. Additionally, a decrease in the species level of Blautia was observed in the Tibetan population. Therefore, the authors suggested that the genus Blautia might play a role in this phenomenon[100]. The genus Blautia consists of bacteria with anti-inflammatory properties that produce butyrate. It may reflect the level of gas production in the gut by converting intestinal gases into short-chain fatty acids[101,102]. Furthermore, there are studies that have compared the composition of the gut microbiota between Han and Tibetan patients with liver cirrhosis. Due to the connection between the liver and gut via the gut-liver axis, there is a strong relationship between the gut microbiome and liver cirrhosis[103,104]. In healthy individuals, the intestinal mucosal barrier and liver detoxification function can prevent bacterial translocation in the gut. However, in patients with liver cirrhosis, impaired liver function leads to increased intestinal permeability, which can further result in dysbiosis and bacterial translocation[105]. Research indicates that among Tibetan individuals suffering from liver cirrhosis, there is a marked increase in the presence of Firmicutes and Actinobacteria, whereas Bacteroidetes are less prevalent in Han individuals with the same condition. When examining genus-level differences, Anaerostipes , Bifidobacterium , and Blautia are more abundant in Tibetans than in Han patients. In contrast, the levels of Alloprevotella , Dorea , and various Prevotella species are lower in Tibetans[106]. To conclude, studies suggest that the gut microbiome’s makeup differs across various ethnicities, particularly in the context of disease, and this could significantly affect the onset of gastrointestinal conditions. It is also clear that ethnic background plays a role in shaping the gut microbiome of the host, highlighting the interconnectedness of gut microbiome and disease within ethnically diverse groups. 3.2 The Relationship Between Gut Microbiota and Cardiovascular Diseases in Ethnic Minority Populations Microbiomes unique to different ethnicities are associated with the onset of cardiovascular conditions. An increasing body of research indicates that the gut microbiome significantly affects GI tract functions, immunity, and psychological well-being via the gut-brain axis. This axis impacts not just digestion but also immune response and nerve signaling, highlighting the pivotal part gut microbiota plays in our general health[107–109]. The burden of ischemic stroke (IS) in China is currently experiencing rapid growth. Despite this, limited research has begun to explore the traits of the gut microbiome among IS sufferers. Among stroke victims or those with transient ischemic attacks in China, there is a notable decrease in the prevalence of key gut microbiome genera including Bacteroides , Prevotella , and Faecalibacterium , conversely, there is an uptick in the presence of potential pathogens like Enterobacter , Alistipes , and Desulfovibrio [110]. Investigating the synergistic impact of gut microbiome and conventional adjustable risk factors for IS in the Tujia, Miao, and Han ethnicities, the study found variations in gut microbiome profiles among stroke sufferers from these groups. IS patients belonging to the Tujia and Miao showed higher levels of Streptococcaceae, while Han patients exhibited a greater incidence of Enterococcaceae and Enterobacteriaceae. The interplay between gut microbiome imbalances and conventional risk factors across these ethnicities is believed to affect stroke susceptibility[111]. It highlights the necessity of recognizing the variance in risk factors among different ethnicities, essential for both the averting and managing of ischemic stroke (IS). Furthermore, research has identified a significant presence of genetic material from gut microbes at lesion sites in coronary artery disease (CAD). This finding suggests that gut bacteria may directly contribute to the development of CAD[112,113]. A study examining the characteristics of gut microbiota in Tibetan CAD patients residing in high-altitude regions revealed that Tibetans exhibit a higher gut microbial α-diversity. In comparision to other ethnic groups, Tibetans have a greater abundance of genera such as Catenibacterium , Clostridium_sensu_stricto , Holdemanella and Ruminococcus_2 . Notably, the abundance of Catenibacterium is higher in high-altitude Tibetans, which may be associated with the progression of CAD. Furthermore, the incidence of CAD among Tibetans living in high-altitude areas is lower than that of the general population[114]. Other studies have also found that in minority (Tibetan) patients with coronary heart disease (CHD), the abundance of the genus Dialister is significantly reduced, while the abundances of Blautia , Dialister , and Succinivibrio are significantly increased. These changes in microbial abundance show a strong correlation with the occurrence of CHD in the Tibetan population[115].Additionally, the microbial community structure in the CHD group showed no statistically significant difference in α-diversity, but there were significant changes in β-diversity[116]. These findings suggest that different ethnic groups have distinct compositions of gut microbiota in the context of cardiovascular diseases, and these compositions have a significant combined effect. 3.3 The Relationship Between Gut Microbiota and Metabolic Diseases in Ethnic Minority Populations It is widely acknowledged that the pathogenesis and etiology of Type II diabetes (T2DM) are not yet fully comprehended. Nevertheless, recent studies have indicated a strong connection between the gut microbiome and the onset of T2DM[117–120]. Limited research has been conducted on the relationship between diabetes in ethnic minorities and their gut microbiota. This knowledge gap encompasses ethnic minorities specific to Yunnan Province, China, including the Dai people. The Dai people predominantly inhabit valley regions and typically engage in endogamy, which refers to the practice of marrying within their own ethnic group[121]. Consequently, a comparison between Han and Dai individuals with T2DM demonstrated that the prevalence of T2DM in the Han population is linked to a significant presence of Bacteroides , whereas in the Dai population, it is associated with a substantial presence of Proteobacteria[122]. There are significant disparities in the incidence rates of T2DM between various ethnic minorities, including the Mongolian population, and the Han population. The gut genus Clostridium is considered to be one of the key microbial groups that influence the T2DM process in the Mongolian population. This is due to the ability of Clostridium species to produce a variety of metabolic enzymes, which has a significant correlation with these bacteria and the enzymes they produce[123]. In 2017, the prevalence of T2DM was 5.76% in the Mongolian population compared to 9.7% in the Han population[124]. A comprehensive comparative analysis of the gut microbiota structures between these two ethnic groups demonstrated that among the Mongolian people, gut microbes such as Fastidiosipila and Barnesiella showed the strongest association with diabetes. Moreover, it was found that there was only a single shared metabolic pathway between these two ethnic groups, which clearly indicates substantial differences in the composition and metabolism of disease-related microbiota among different ethnicities[125]. Furthermore, the incidence of Type 2 diabetes (T2DM) among the Kazakh ethnic group (1.56%) is markedly less than among the Uyghur ethnic group (8.42%)[126]. The analysis of the gut microbiome of T2DM patients from the two ethnic groups revealed that Kazakh T2DM patients had a high abundance of Desulfovibrionaceae and Aeromonadaceae in their gut microbiome, while Uyghur patients exhibited high levels of Erysipelotrichaceae [79]. Given the lower prevalence of T2DM among the Kazakh population, it is possible that their gut microbiome contains beneficial bacteria that help prevent and reduce the incidence of T2DM. This hypothesis warrants further investigation. Research materials indicate that studies have been conducted on the relationship between gut bacteria and diseases in Tibetan, Mongolian, Miao, and Dai populations, with a higher frequency of publications on Tibetan gut microbiota. Table 1 presents a summary of pertinent studies on the relationship between gut microbiota and diseases in Chinese ethnic minorities. Table 1 . Studies on the connection between gut microbiota and diseases among ethnic minority groups in China. 1. Uyghur, Han Ulcerative Colitis (UC) Burkholderia Caballeronia Paraburkholderia Differences in gut microbiota composition may be a factor contributing to the heterogeneous clinical manifestations of UC patients between the Uyghur and Han ethnic groups. Haemophilus and Ezakiella could serve as potential biomarkers for predicting UC [95]. 2. Tibetan, Han Irritable Bowel Syndrome (IBS) Firmicutes,Bacteroidetes Blautia Owing to the distinct features of the gut microbiome in Tibetan versus Han individuals with Irritable Bowel Syndrome (IBS), the presence of Blautia could make Tibetan IBS sufferers more susceptible to experiencing bloating [100]. 3. Tibetan Liver Cirrhosis Anaerostipes Bifidobacterium,Dorea Tibetan cirrhosis patients exhibit a high abundance of Firmicutes and Actinobacteria ( P = 0.01 and 0.03, respectively) [106]. 4. Tujia Miao,Han Ischemic Stroke (IS) Enterococcaceae Streptococcaceae There is an interaction between traditional IS risk factors (systolic blood pressure, diastolic blood pressure, and high-sensitivity C-reactive protein) and the gut microbiota of ethnic minority hosts [111]. 5. Tibetan Coronary Artery Disease (CAD) Catenibacterium Holdemanella Ruminococcus The unique living environment and dietary habits of high-altitude Tibetans mediate changes in their gut microbiota, resulting in a lower prevalence of coronary artery disease (CAD) compared to the general population [114]. 6. Tibetan Coronary Heart Disease (CHD) Dialister,Succinivibrio Blautia Ethnicity and environment significantly influence the gut microbiota of Tibetans. Coronary heart disease (CHD) is closely associated with the gut microbiota of Tibetans [115]. 7. Dai,Han TypeII Diabetes (T2DM) Bacteroides Proteobacteria In the Han population, a significant increase in Bacteroidetes is associated with the occurrence of type 2 diabetes (T2DM), whereas in the Dai population, a significant increase in Proteobacteria is associated with the occurrence of T2DM [122]. 8. Kazakh Uyghur Mongolian Diabetes Clostridium , Fastidiosipilla Barnesiella,Aeromonadaceae Desulfovibrionaceae Erysipelotrichaceae There are significant differences in the composition and function of bacteria associated with diabetes among different ethnic groups. When studying the association between diabetes and gut microbiota, the impact of ethnic differences should be fully considered [125,126]. 4. CONCLUSION China’s vast territory and complex terrain have led to the emergence of distinct and predominant bacterial groups in various provinces. For example, Methylobacterium , Halococcus , and Fusobacterium are found in abundance in Heilongjiang, Liaoning, and Jiangxi provinces, respectively, while Holdemania , Bacillus , and Enhydrobacter dominate in Guangxi, Guangdong, and Zhejiang provinces. This geographical variation partially explains the regional characteristics of the human gut microbiome in China. The Bai, Kazakh, Mongolian, Tibetan, Uighur, and Zhuang peoples are representative ethnic minorities in China. These minorities are dispersed across various provinces, with certain groups still preserving their distinct traditional cultures, lifestyles, dietary habits, and living environments. These unique features make China an ideal model for investigating how these factors influence the structure of the gut microbiota. The gut microbiota’s structure and composition in ethnic minorities are significantly influenced by diverse factors. Consequently, investigating the connection between ethnicity and the gut microbiota holds considerable academic and practical significance As research on the gut microbiota advances and research techniques become more sophisticated, studies on the gut microecology of the Chinese population are increasing. Investigating the gut microbiota of ethnic minorities, who play a crucial role in social construction and cultural development, enhances our understanding of human microbial diversity. Differences in gut microbiota composition have been observed among ethnic groups with the same disease. The gut microbiota profiles of diabetic patients from the Dai ethnic group and the Han ethnic group exhibit significant differences. The Dai ethnic group’s diabetic patients have a higher abundance of Proteobacteria, whereas the Han ethnic group’s diabetic patients have a higher abundance of Bacteroidetes. Furthermore, specific gut bacteria have been linked to the prevalence of certain diseases among different ethnic groups. Take for instance, Tibetan individuals tend to have elevated levels of Fusarium and Zopfiella within their gut microbiome, potentially linking to a higher likelihood of developing cardiovascular conditions. Likewise, the frequent occurrence of atherosclerosis among Mongolians is believed to correlate with a higher presence of Collinsella in their gut microbiome. Currently, studies focusing on the gut microbiome within ethnic minority groups are scarce, primarily focusing on common minority groups, with little understanding of those living in remote areas. Although ethnicity is one of the factors influencing gut microbiota composition, the impact of geographical location is significant. However, most studies on the gut microecology of ethnic minorities have not emphasized this point. Overall, understanding the microbial differences between different populations and their potential health impacts is of great importance. In future research endeavors, a more in-depth exploration of the connection between the gut microbiota of ethnic minorities and health can be undertaken. This will offer more profound theoretical underpinnings for personalized medicine and health management strategies. Acknowledgements: None. Consent for publication: All authors agree to the publication of this manuscript. Competing interests : None of the authors had any conflict of interest with any pharmaceutical companies or organizations in carrying out this study. Funding: This study was supported by the National Key R&D Program of China (2024YFA1308300) and the National Natural Science Foundation of China (No.82460112), National Natural Science Foundation of China (No.32100009) and Shenzhen Municipal Government of China (No. XMHT20220104017). Availability of data and materials : All data analyzed and presented in this study are available from the corresponding author on reasonable request. Ethical approval： Not applicable. Credit author statement: Y . S . and Y . Z .: Conceptualization, Funding acquisition and Supervision. B . L ., H . W .and M . W .: Data analysis and Methodology. B . X .， X . Y .: Data curation. B . X .: Visualization and Writing original draft. Y . S ., Y . Z .,and Y . 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Keywords gut bacteria human microbiome microbiome Authors Affiliations Binbin Xia 0009-0005-7439-0376 First Affiliated Hospital of Kunming Medical University View all articles by this author Xinbi First Affiliated Hospital of Kunming Medical University View all articles by this author Bo Li First Affiliated Hospital of Kunming Medical University View all articles by this author Haoyu Wang BGI Group View all articles by this author Mengmeng Wang BGI Group View all articles by this author Yuanqiang Zou [email protected] BGI Group View all articles by this author Yinglei Miao First Affiliated Hospital of Kunming Medical University View all articles by this author Yang Sun First Affiliated Hospital of Kunming Medical University View all articles by this author Metrics & Citations Metrics Article Usage 789 views 174 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Binbin Xia, Xinbi, Bo Li, et al. 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