Altered gut microbiota composition in adults with chronic subdural hematoma: a case-control study
4 affiliations
- 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- 2China National Clinical Research Center for Neurological Diseases, Beijing, China
- 3Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- 4Department of Neurosurgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
Abstract
Background and purposeChronic subdural hematoma (CSDH) is increasingly recognized as a dynamic inflammatory and angiogenic disorder, but whether it is associated with alterations in the gut microbiota remains unclear. We therefore characterized the gut microbial profiles of adults with CSDH and healthy controls (HCs).MethodsWe conducted an observational case-control study of 40 adults with CSDH and 96 HCs. Fecal bacterial communities were profiled by 16S rRNA gene sequencing. We assessed alpha and beta diversity, identified differentially abundant genera using covariate-adjusted centered log-ratio models with false-discovery-rate correction, evaluated genus-level discrimination using a random forest classifier with repeated nested cross-validation, and examined associations with clinical characteristics using partial Spearman correlations.ResultsThere was no clear evidence of an alpha-diversity difference after covariate adjustment. Community structure differed across Bray-Curtis, weighted UniFrac, and unweighted UniFrac distances (all P = 0.001), with the largest explained variance for weighted UniFrac (R² = 0.106). Thirteen genera remained significant after adjustment and multiple-testing correction, including sensitivity analyses that additionally accounted for diabetes and recorded medication exposure. Collinsella and Dorea were more abundant in CSDH, whereas Bacteroides was more abundant in HCs. Across 10 repeated outer cross-validation partitions, the mean out-of-fold area under the receiver-operating-characteristic curve was 0.938 ± 0.010; averaging participant-level out-of-fold probabilities yielded an area under the curve of 0.951. Dorea was positively associated with diabetes, and Bacteroides was inversely associated with cerebral infarction after false-discovery-rate correction.ConclusionsAdults with CSDH showed differences in gut microbial community structure and genus-level composition, without clear evidence of an alpha-diversity difference. These are exploratory associations in a selected case-control sample. The cross-sectional, single-center design precludes causal inference, and the classifier has not established calibration, external validity or clinical utility.
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BibTeX
@article{li2026altered,
title = {{Altered gut microbiota composition in adults with chronic subdural hematoma: a case-control study}},
author = {Yunfei Li and Yunfei Li and Xiaofan Yu and Chaoqun Lin and Chaoqun Lin and Guoyi Gao and Guoyi Gao and Weiming Liu and Liang Wu and Liang Wu},
journal = {Frontiers in Cellular and Infection Microbiology},
year = {2026},
month = oct,
doi = {10.3389/fcimb.2026.1962090},
url = {https://doi.org/10.3389/fcimb.2026.1962090},
note = {CC BY},
}
RIS
TY - JOUR
TI - Altered gut microbiota composition in adults with chronic subdural hematoma: a case-control study
AU - Yunfei Li
AU - Yunfei Li
AU - Xiaofan Yu
AU - Chaoqun Lin
AU - Chaoqun Lin
AU - Guoyi Gao
AU - Guoyi Gao
AU - Weiming Liu
AU - Liang Wu
AU - Liang Wu
PY - 2026
DA - 2026/10/23
JO - Frontiers in Cellular and Infection Microbiology
DO - 10.3389/fcimb.2026.1962090
UR - https://doi.org/10.3389/fcimb.2026.1962090
AB - Background and purposeChronic subdural hematoma (CSDH) is increasingly recognized as a dynamic inflammatory and angiogenic disorder, but whether it is associated with alterations in the gut microbiota remains unclear. We therefore characterized the gut microbial profiles of adults with CSDH and healthy controls (HCs).MethodsWe conducted an observational case-control study of 40 adults with CSDH and 96 HCs. Fecal bacterial communities were profiled by 16S rRNA gene sequencing. We assessed alpha and beta diversity, identified differentially abundant genera using covariate-adjusted centered log-ratio models with false-discovery-rate correction, evaluated genus-level discrimination using a random forest classifier with repeated nested cross-validation, and examined associations with clinical characteristics using partial Spearman correlations.ResultsThere was no clear evidence of an alpha-diversity difference after covariate adjustment. Community structure differed across Bray-Curtis, weighted UniFrac, and unweighted UniFrac distances (all P = 0.001), with the largest explained variance for weighted UniFrac (R² = 0.106). Thirteen genera remained significant after adjustment and multiple-testing correction, including sensitivity analyses that additionally accounted for diabetes and recorded medication exposure. Collinsella and Dorea were more abundant in CSDH, whereas Bacteroides was more abundant in HCs. Across 10 repeated outer cross-validation partitions, the mean out-of-fold area under the receiver-operating-characteristic curve was 0.938 ± 0.010; averaging participant-level out-of-fold probabilities yielded an area under the curve of 0.951. Dorea was positively associated with diabetes, and Bacteroides was inversely associated with cerebral infarction after false-discovery-rate correction.ConclusionsAdults with CSDH showed differences in gut microbial community structure and genus-level composition, without clear evidence of an alpha-diversity difference. These are exploratory associations in a selected case-control sample. The cross-sectional, single-center design precludes causal inference, and the classifier has not established calibration, external validity or clinical utility.
SN - 2235-2988
ER -