Basic Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2022; 28(27): 3455-3475
Published online Jul 21, 2022. doi: 10.3748/wjg.v28.i27.3455
Associations of gut microbiota with dyslipidemia based on sex differences in subjects from Northwestern China
Lei Guo, Yang-Yang Wang, Ji-Han Wang, He-Ping Zhao, Yan Yu, Guo-Dong Wang, Kun Dai, Yu-Zhu Yan, Yan-Jie Yang, Jing Lv
Lei Guo, Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
Yang-Yang Wang, School of Electronics and Information, Northwestern Polytechnical University, Xi'an 710129, Shaanxi Province, China
Ji-Han Wang, Institute of Medical Research, Northwestern Polytechnical University, Xi'an 710072, Shaanxi Province, China
He-Ping Zhao, Yan Yu, Yu-Zhu Yan, Jing Lv, Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
Guo-Dong Wang, Department of Quality Control, Xi’an Mental Health Center, Xi'an 710100, Shaanxi Province, China
Kun Dai, Department of Clinical Laboratory, Yanliang Railway Hospital of Xi’an, Xi'an 710089, Shaanxi Province, China
Yan-Jie Yang, Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Author contributions: All the authors solely contributed to this article; Guo L and Lv J searched and reviewed published articles, interpreted data, constructed tables, drafted the article, and made substantial contributions to the conception and design of this study; Wang YY, Wang JH and Yan YZ conducted the experiments, performed sequencing analysis and constructed the figures; Wang YY, Wang JH and Wang GD performed statistical analysis; Zhao HP, Yu Y and Dai K constructed the figures and tables; Yang YJ contributed to the conception of the study; and all authors critically reviewed the manuscript, and approved the final version to be published.
Supported by Youth Program of Xi'an Municipal Health Commission of China, No. 2022qn07; General Program of Xi'an Municipal Health Commission of China, No. 2020ms14; and National Natural Science Foundation of China, No. 81702067.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Honghui Hospital, Xi’an Jiaotong University, No. 201801022.
Informed consent statement: All study participants provided informed consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The raw data supporting the conclusions of this article available from the corresponding author at
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jing Lv, MD, Doctor, Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, No. 555 You Yi Dong Road, Xi'an 710054, Shaanxi Province, China.
Received: February 18, 2022
Peer-review started: February 18, 2022
First decision: May 9, 2022
Revised: May 17, 2022
Accepted: June 20, 2022
Article in press: June, 20, 2022
Published online: July 21, 2022

The gut microbiota (GM) has been proven to play a role in the regulation of host lipid metabolism, which provides a new theory about the pathogenesis of dyslipidemia. However, the associations of GM with dyslipidemia based on sex differences remain unclear and warrant elucidation.


To investigate the associations of GM features with serum lipid profiles based on sex differences in a Chinese population.


This study ultimately recruited 142 participants (73 females and 69 males) at Honghui Hospital, Xi’an Jiaotong University. The anthropometric and blood metabolic parameters of all participants were measured. According to their serum lipid levels, female and male participants were classified into a high triglyceride (H_TG) group, a high total cholesterol (H_CHO) group, a low high-density lipoprotein cholesterol (L_HDL-C) group, and a control (CON) group with normal serum lipid levels. Fresh fecal samples were collected for 16S rRNA gene sequencing. UPARSE software, QIIME software, the RDP classifier and the FAPROTAX database were used for sequencing analyses.


The GM composition at the phylum level included Firmicutes and Bacteroidetes as the core GM. Different GM features were identified between females and males, and the associations between GM and serum lipid profiles were different in females and males. The GM features in different dyslipidemia subgroups changed in both female patients and male patients. Proteobacteria, Lactobacillaceae, Lactobacillus and Lactobacillus_salivarius were enriched in H_CHO females compared with CON females, while Coriobacteriia were enriched in L_HDL-C females. In the comparison among the three dyslipidemia subgroups in females, Lactobacillus_salivarius were enriched in H_CHO females, and Prevotellaceae were enriched in L_HDL-C females. Compared with CON or H_TG males, Prevotellaceae, unidentified_Ruminococcaceae, Roseburia and Roseburia_inulinivorans were decreased in L_HDL-C males (P value < 0.05), and linear discriminant analysis effect size analysis indicated an enrichment of the above GM taxa in H_TG males compared with other male subgroups. Additionally, Roseburia_inulinivorans abundance was positively correlated with serum TG and total cholesterol levels, and Roseburia were positively correlated with serum TG level. Furthermore, Proteobacteria (0.724, 95%CI: 0.567-0.849), Lactobacillaceae (0.703, 95%CI: 0.544-0.832), Lactobacillus (0.705, 95%CI: 0.547-0.834) and Lactobacillus_salivarius (0.706, 95%CI: 0.548-0.835) could distinguish H_CHO females from CON females, while Coriobacteriia (0.710, 95%CI: 0.547-0.841), Coriobacteriales (0.710, 95%CI: 0.547-0.841), Prevotellaceae (0.697, 95%CI: 0.534-0.830), Roseburia (0.697, 95%CI: 0.534-0.830) and Roseburia_inulinivorans (0.684, 95%CI: 0.520-0.820) could discriminate H_TG males from CON males. Based on the predictions of GM metabolic capabilities with the FAPROTAX database, a total of 51 functional assignments were obtained in females, while 38 were obtained in males. This functional prediction suggested that cellulolysis increased in L_HDL-C females compared with CON females, but decreased in L_HDL-C males compared with CON males.


This study indicates associations of GM with serum lipid profiles, supporting the notion that GM dysbiosis may participate in the pathogenesis of dyslipidemia, and sex differences should be considered.

Keywords: Dyslipidemia, Gut microbiota, 16S rRNA, Sequencing, Sex differences, Northwestern China

Core Tip: Dyslipidemia is the circulating lipid expression of metabolic syndrome, and alterations of gut microbiota (GM) are indicated to participate in the pathogenesis of dyslipidemia; however, little evidence was found in the literature on sex differences for these associations. Our results demonstrated the GM features in different dyslipidemia subgroups in females and males, suggesting a complex interaction between GM and lipid metabolism. Our observations may provide new evidence that different GM taxa may be associated with distinct lipids, and that GM may affect specific aspects of lipid metabolism. More studies are required to propose specific taxa that have the potential to ameliorate dyslipidemia.