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Objective To explore the influencing factors of different types of small intestinal bacterial overgrowth (SIBO). Methods A total of 539 patients who were hospitalized in the Department of Gastroenterology, the Sixth Medical Center of PLA General Hospital from June 2021 to December 2021 and who underwent methane-hydrogen breath test were retrospectively selected. Based on breath test results, patients were divided into SIBO-negative group (n=300) and SIBO-positive group (n=239). The clinical data were compared between two groups. According to the specific values of breath test results, SIBO-positive patients were further divided into hydrogen-producing bacterial overgrowth (hydrogen-positive, n=103), intestinal methanogen overgrowth (methanogen-positive, n=80), and simultaneous methanogen and hydrogen-producing bacterial overgrowth (double positive, n=56) groups. Multivariate logistic regression analysis was employed to identify influencing factors of different SIBO types. Additionally, SIBO-positive patients were categorized by age into <45 years (n=23), 45-60 years (n=82), 60-75 years (n=124), and ≥75 years (n=10) to compare SIBO positivity rates across age groups. Results The patients in SIBO-positive and double positive groups were older and had a lower body mass index (BMI) than those in SIBO-negative group, with statistically significant differences (P<0.05). Compared with the patients in SIBO-negative group, those in hydrogen-positive group showed a higher proportion of history of coronary heart disease, those in methanogen-positive group were older, and higher proportion of statin use, with statistically significant differences (P<0.05). Multivariate logistic regression analysis revealed that, among different SIBO types, a history of coronary heart disease served as an independent risk factor for hydrogen-producing bacterial overgrowth (OR=2.728, 95%CI 1.271-5.857, P=0.010). For methanogen overgrowth, increasing age was identified as an independent risk factor (OR=1.040, 95%CI 1.009-1.063, P=0.010), while the application of statin played the role of an independent protective factor (OR=0.420, 95%CI 0.236-0.754, P=0.003). As for the simultaneous overgrowth of methane-producing and hydrogen-producing bacteria, increased BMI was found to be an independent protective factor (OR=0.870, 95%CI 0.786-0.964, P=0.008). In SIBO-positive group, it was found that for patients aged <45 years, both the methane-positive rate and the double-positive rate were significantly lower than the hydrogen positivity rate (P<0.05). Moreover, among patients aged 45-60 years, the double-positive rate was significantly lower than the hydrogen positivity rate (P<0.01). When it comes to the hydrogen-positive rate, it was significantly lower for patients aged 45-60 and 60-75 years compared with that of patients aged <45 years (P<0.05). In contrast, the methane-positive rate and the double-positive rate were significantly higher for patients aged 45-60 and 60-75 years than those of patients aged <45 years (P<0.01). Conclusion A history of coronary heart disease and increasing age are independent risk factors for intestinal hydrogen-producing bacterial overgrowth and methanogen overgrowth, respectively. The application of statins and increased BMI are independent protective factors for intestinal methanogen simultaneous overgrowth of methanogen and hydrogen-producing bacteria, respectively.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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