Background:Osteoporosis (OP) has become a major public health issue, threatening the bone health of middle-aged and elderly people from all around the world. Changes in the gut microbiota (GM) are correlated with the maintenance of bone mass and bone quality. However, research results in this field remain highly controversial, and no systematic review or meta-analysis of the relationship between GM and OP has been conducted. This paper addresses this shortcoming, focusing on the difference in the GM abundance between OP patients and healthy controls based on previous 16S ribosomal RNA (rRNA) gene sequencing results, in order to provide new clinical reference information for future customized prevention and treatment options of OP. Methods:According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we comprehensively searched the databases of PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI). In addition, we applied the R programming language version 4.0.3 and Stata 15.1 software for data analysis. We also implemented the Newcastle-Ottawa Scale (NOS), funnel plot analysis, sensitivity analysis, Egger's test, and Begg's test to assess the risk of bias. Results:This research ultimately considered 12 studies, which included the fecal GM data of 2033 people (604 with OP and 1429 healthy controls). In the included research papers, it was observed that the relative abundance of Lactobacillus and Ruminococcus increased in the OP group, while the relative abundance for Bacteroides of Bacteroidetes increased (except for Ireland). Meanwhile, Firmicutes, Blautia, Alistipes, Megamonas, and Anaerostipes showed reduced relative abundance in Chinese studies. In the linear discriminant analysis Effect Size (LEfSe) analysis, certain bacteria showed statistically significant results consistently across different studies. Conclusions:This observational meta-analysis revealed that changes in the GM were correlated with OP, and variations in some advantageous GM might involve regional differences.

Rui HUANG;Pan LIU;Yiguang BAI;Jieqiong HUANG;Rui PAN;Huihua LI;Yeping SU;Quan ZHOU;Ruixin MA;Shaohui ZONG;Gaofeng ZENG

College of Public Hygiene of Guangxi Medical University,Nanning 530021,China;Department of Spine Osteopathic,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Orthopaedics,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China;Department of Orthopaedics,Nanchong Central Hospital,the Second Clinical Institute of North Sichuan Medical College,Nanchong 637000,China;Department of Wound Repair,the First People's Hospital of Nanning,Nanning 530022,China

浙江大学学报（英文版）（B辑：生物医学和生物技术）

[1]Rui HUANG;Pan LIU;Yiguang BAI;Jieqiong HUANG;Rui PAN;Huihua LI;Yeping SU;Quan ZHOU;Ruixin MA;Shaohui ZONG;Gaofeng ZENG-.Changes in the gut microbiota of osteoporosis patients based on16S rRNA gene sequencing:a systematic review and meta-analysis)[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2022(12):1002-1013,中插7-中插14

on16S

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