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. 2022 Nov 25;14(23):5013.
doi: 10.3390/nu14235013.

Association between Depression, Anxiety Symptoms and Gut Microbiota in Chinese Elderly with Functional Constipation

Jiajing Liang  1 , Yueming Zhao  2 , Yue Xi  1   3 , Caihong Xiang  1 , Cuiting Yong  1 , Jiaqi Huo  1 , Hanshuang Zou  1 , Yanmei Hou  2 , Yunfeng Pan  1 , Minchan Wu  1 , Qingqing Xie  1 , Qian Lin  1
Affiliations

Association between Depression, Anxiety Symptoms and Gut Microbiota in Chinese Elderly with Functional Constipation

Jiajing Liang et al. Nutrients. .

Abstract

This study aimed to investigate the relationship between anxiety, depression, and gut microbiota in elderly patients with FC.

Methods: in this cross-sectional study, a total of 198 elderly participants (85 male and 113 female) aged over 60 years were recruited. The study was conducted in Changsha city, China. The participants completed an online questionnaire, including The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), The Patient Assessment of Symptoms (PAC-SYM), and The Patient Assessment of Quality of Life (PAC-QoL). We selected the 16S rDNA V3 + V4 region as the amplification region and sequenced the gut microbiota using the Illumina Novaseq PE250 high-throughput sequencing platform.

Results: in total, 30.3% of patients with constipation had depression, while 21.3% had anxiety. The relative abundance of intestinal microbiota in the normal group was higher than that in the anxiety and depression group. According to LEfSe analysis, the relative abundance of g_Peptoniphilus and g_Geobacter in the people without depression and anxiety was higher. The relative abundance of g_Pseudoramibacter-Eubacterium and g_Candidatus-Solibacter in the depression group was lower, and the relative abundance of g_Bacteroides and g_Paraprevotella, g_Cc_115 in the anxiety group was higher. In addition, according to the correlation analysis, g_Aquicella and g_Limnohabitans were negatively correlated with constipation symptoms, anxiety, and depression.

Conclusions: this study found that gut microbiota composition may be associated with a higher incidence of anxiety and depression in patients with FC, thus providing insight into the mechanisms that ameliorate mood disorders in patients with FC.

Keywords: anxiety; constipation; depression; elderly; intestinal flora.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study in the collection, analyses, or interpretation of data; in the writing of the manuscript; in the decision to publish the results.

Figures

Figure 1
Figure 1
Correlation between depression, anxiety, and constipation symptoms. Faeces, rectum, and abdomen represent the dimensions of stool traits, rectal symptoms, and abdominal symptoms of PAC-SYM, respectively. Total-con: PAC-SYM (Patient Assessment of Constipation symptom) total score; depressed: PHQ-9 total score; anxious: GAD-7 total score. In addition, the correlation coefficient between anxiety and depression is high, 0.61 (p < 0.05), but through collinearity analysis, VIF = 1 of the two, and there is no evidence to show that there is collinearity. ** p < 0.01, *** p < 0.001.
Figure 2
Figure 2
Gut microbiota in depression. (a) Comparison of intestinal microbiota OTUs between depression group and non-depression group. (b) The relative abundance of intestinal microbiota in the depressed group and the non-depressed group. (c) Shannon diversity of gut microbiota in depressed and non-depressed groups. (d) Chao-1 index of gut microbiota in depressed and non-depressed group. (e) Principal coordinate analysis (PCoA) of gut microbiota in depressed and non-depressed groups, p values were obtained by PERMANOVA and ANOSIM analysis. The black dots in (c,d) are outliers (values 1.5 standard deviations above the upper and lower edges of the box diagram). ns: no significance, p > 0.05.
Figure 3
Figure 3
Gut microbiota in anxiety. (a) Comparison of intestinal microbiota OTUs between anxiety group and non-anxiety group. (b) The relative abundance of intestinal microbiota in the anxiety group and non-anxiety group. (c) Shannon diversity of gut microbiota in anxiety and non-anxiety groups. (d) Chao-1 index of gut microbiota in anxiety and non-anxiety groups. (e) Principal coordinate analysis (PCoA) of gut microbiota in anxiety and non-anxiety groups, p values were obtained by PERMANOVA and ANOSIM analysis. The black dots in (c,d) are outliers (values 1.5 standard deviations above the upper and lower edges of the box diagram). ns: no significance, p > 0.05.
Figure 4
Figure 4
LEfSe analysis of the LDA histogram: (a) intestinal flora difference between depression group and non-depression group; (b) intestinal flora difference between anxiety group and non-anxiety group.
Figure 5
Figure 5
Heat map of interrelationships between genus level microbial species and phenotypes. Rectum, faeces, and abdomen represent the dimensions of rectal symptoms, stool traits, and abdominal symptoms of PAC-SYM, respectively. GAD and PHQ are the scores of GAD-7 and PHQ-9, respectively. * 0.01 ≤ p < 0.05, ** 0.001 ≤ p < 0.01, *** p < 0.001.
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References

    1. Bharucha A.E., Lacy B.E. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020;158:1232–1249.e3. doi: 10.1053/j.gastro.2019.12.034. - DOI - PMC - PubMed
    1. Ji H., Xie R., Zhang Y., Lu Q., Huang H., Chen M., Zhang F. Individuals with persistent constipation tend to self-medicate and abuse drugs, which could affect the optimal timing of treatment and exacerbate the disease; all of these would impact the quality of life and lead to other chronic diseases. Chin. J. Clin. Healthc. 2022;25:337–340.
    1. Cheng C., Chan A.O., Hui W.M., Lam S.K. Coping strategies, illness perception, anxiety and depression of patients with idiopathic constipation: A population-based study. Aliment. Pharmacol. Ther. 2003;18:319–326. doi: 10.1046/j.1365-2036.2003.01663.x. - DOI - PubMed
    1. Albiani J.J., Hart S.L., Katz L., Berian J., Del Rosario A., Lee J., Varma M. Impact of depression and anxiety on the quality of life of constipated patients. J. Clin. Psychol. Med. Settings. 2013;20:123–132. doi: 10.1007/s10880-012-9306-3. - DOI - PubMed
    1. Fond G., Loundou A., Hamdani N., Boukouaci W., Dargel A., Oliveira J., Roger M., Tamouza R., Leboyer M., Boyer L. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): A systematic review and meta-analysis. Eur. Arch. Psychiatry Clin. Neurosci. 2014;264:651–660. doi: 10.1007/s00406-014-0502-z. - DOI - PubMed

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