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ORIGINAL RESEARCH article

Front. Microbiol.

Sec. Microorganisms in Vertebrate Digestive Systems

Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1663716

This article is part of the Research TopicThe Role of Gut Microbes and Their Metabolites in Metabolic Diseases: Mechanisms and Therapeutic TargetsView all 19 articles

Gut Microbiota and Metabolite Characteristics and Connections in Different Traditional Chinese Medicine Types of Osteoporosis

Provisionally accepted
Zixiang  GengZixiang Geng*Long  YuanLong YuanDiHang  XuDiHang XuYongfang  ZhaoYongfang Zhao
  • Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China

The final, formatted version of the article will be published soon.

The occurrence of osteoporosis is closely related to alterations in the gut microbiota. Traditional Chinese Medicine (TCM) classifies osteoporosis into distinct subtypes based on clinical symptomatology and underlying pathological patterns, which may reflect differences in host physiology and metabolic milieu. However, the characteristics of the gut microbiota across these TCM subtypes remain poorly understood. This study aims to investigate whether TCM-based classification of osteoporosis corresponds to specific gut microbial and metabolic profiles, thereby providing a microbiological basis for syndrome differentiation. Body composition analysis was performed using dual-energy X-ray absorptiometry in healthy elderly subjects and patients with different TCM types of osteoporosis. Gut microbiota and metabolites were assessed via 16S rRNA sequencing and LC-MS/MS. The results showed that the gut microbiota dysbiosis index was significantly elevated in osteoporosis patients compared to healthy controls, and was highest in those with spleen-kidney Yang deficiency type. Intestinibacter and Phascolarctobacterium were significantly enriched in kidney Yang deficiency osteoporosis, while Olsenella was markedly increased in spleen-kidney Yang deficiency osteoporosis. Intestinibacter and Phascolarctobacterium abundance negatively correlated with bone mineral density at multiple sites, whereas Olsenella was negatively associated with appendicular skeletal muscle index. Importantly, microbial metabolism in kidney Yang deficiency type was linked to vitamin D metabolism, whereas in spleen-kidney Yang deficiency type it was associated with lipid metabolism. These findings suggest that TCM classification captures meaningful biological heterogeneity in osteoporosis, reflected in distinct microbiome and metabolic signatures that may inform personalized approaches to diagnosis and treatment.

Keywords: Gut Microbiota, Osteoporosis, Troditional Chinese Medicine, Kidney yang deficiency syndrome, Spleen-kidney Yang Deficiency

Received: 10 Jul 2025; Accepted: 29 Sep 2025.

Copyright: © 2025 Geng, Yuan, Xu and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Zixiang Geng, gengzx@foxmail.com

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