Effects of soluble dietary fiber on intestinal microecology in patients with severe cerebral hemorrhages

doi:10.3877/cma.j.issn.2095-9141.2026.01.005

Abstract

Abstract:

Objective

To investigate the effect of enteral nutrition preparations rich in soluble dietary fiber (SDF) on the gut microbiota of patients with severe cerebral hemorrhage.

Methods

Prospective inclusion of severe cerebral hemorrhage patients admitted to the Neurosurgery Intensive Care Unit of Changzhou First People's Hospital from March 2023 to August 2024 as the study subjects. Using a random number table, patients were divided into an SDF group (receiving enteral nutrition preparations containing SDF) and a Non-SDF group (receiving enteral nutrition preparations without SDF). After 7 d of enteral nutrition intervention, fecal samples were collected for metagenomic sequencing to compare the differences in gut microbiota diversity and composition between two groups of patients; Linear discriminant analysis (LEfSe) was used to screen for inter group differential bacteria, and a random forest model was used to evaluate the feature importance of differential bacteria in order to screen for potential biomarkers; canonical correspondence analysis (CCA) was used to analyze the correlation between microbiota and clinical indicators.

Results

A total of 42 patients with severe cerebral hemorrhage were included in this group, including 18 cases in the SDF group and 24 cases in the Non-SDF group. There was no statistically significant difference in the α and β diversity of gut microbiota between the two groups of patients (P>0.05). Compared with the Non-SDF group, the SDF group showed an increase in the relative abundance of Fecal pseudomonas (P=0.025) and a decrease in the relative abundance of Escherichia coli (P=0.042). LEfSe analysis showed that six discriminative biomarkers were ultimately identified at the species level, of which four were enriched in the SDF group, including Bacteroides faecalis, Fecal pseudomonas, Methanobacterium faecalis, and Streptococcus pyogenes; Two were enriched in the Non-SDF group, including Enterococcus faecalis and Vibrio cholerae. Random forest model analysis showed that Fecal pseudomonas had the highest importance in both permutation importance and Gini coefficient importance ranking in the random forest model. CCA analysis showed that Pseudomonas aeruginosa and Bacteroidetes fragilis were associated with neurological damage and decreased levels of consciousness, while Pseudomonas aeruginosa and Escherichia coli were associated with immune response and inflammatory processes.

Conclusions

SDF enteral nutrition intervention for 7 d did not significantly change the overall diversity of gut microbiota in patients with severe cerebral hemorrhage, but it can selectively regulate the abundance of key bacterial species, and some bacterial species abundance is significantly correlated with neurological function/consciousness status and immune inflammatory indicators.

Key words: Severe cerebral hemorrhage, Soluble dietary fiber, Enteral nutrition, Gut microbiota

Yi Feng, Geng Jia, Lu Chen, Huaping Qin, Changchun Yang, Naiyuan Shao, Ya Peng. Effects of soluble dietary fiber on intestinal microecology in patients with severe cerebral hemorrhages[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2026, 12(01): 30-38.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2026.01.005

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2026/V12/I01/30

Figures/Tables 6

References 38

[1]	Gabriele F, Foschi M, Conversi F, et al. Epidemiology and outcomes of intracerebral hemorrhage associated with oral anticoagulation over 10 years in a population-based stroke registry[J]. Int J Stroke, 2024, 19(5): 515-525. DOI: 10.1177/17474930231218594.
[2]	McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically Ⅲ patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)[J]. JPEN J Parenter Enteral Nutr, 2016, 40(2): 159-211. DOI: 10.1177/0148607115621863.
[3]	Hill TL. Gastrointestinal tract dysfunction with critical Illness: clinical assessment and management[J]. Top Companion Anim Med, 2019, 35: 47-52. DOI: 10.1053/j.tcam.2019.04.002.
[4]	Elsasser TH, Faulkenberg S. Physiology of gut water balance and pathomechanics of diarrhea[M]. Cham: Springer, 2024: 179-209.
[5]	Xu T, Wu X, Liu J, et al. The regulatory roles of dietary fibers on host health via gut microbiota-derived short chain fatty acids[J]. Curr Opin Pharmacol, 2022, 62: 36-42. DOI: 10.1016/j.coph.2021.11.001.
[6]	Reider SJ, Moosmang S, Tragust J, et al. Prebiotic effects of partially hydrolyzed guar gum on the composition and function of the human microbiota-results from the PAGODA trial[J]. Nutrients, 2020, 12(5): 1257. DOI: 10.3390/nu12051257.
[7]	Pi XE, Fu H, Yang XX, et al. Bacterial, short-chain fatty acid and gas profiles of partially hydrolyzed guar gum in vitro fermentation by human fecal microbiota[J]. Food Chem, 2024, 430: 137006. DOI: 10.1016/j.foodchem.2023.137006.
[8]	Giannini EG, Mansi C, Dulbecco P, et al. Role of partially hydrolyzed guar gum in the treatment of irritable bowel syndrome[J]. Nutrition, 2006, 22(3): 334-342. DOI: 10.1016/j.nut.2005.10.003.
[9]	Wozniak H, Beckmann TS, Fröhlich L, et al. The central and biodynamic role of gut microbiota in critically ill patients[J]. Crit Care, 2022, 26(1): 250. DOI: 10.1186/s13054-022-04127-5.
[10]	Lu X, Liu J, Zhou B, et al. Microbial metabolites and heart failure: friends or enemies?[J]. Front Microbiol, 2022, 13: 956516. DOI: 10.3389/fmicb.2022.956516.
[11]	Strain R, Tran TTT, Mills S, et al. A pilot study of dietary fibres on pathogen growth in an ex vivo colonic model reveals their potential ability to limit vancomycin-resistant enterococcus expansion[J]. Microbiome Res Rep, 2023, 2(3): 22. DOI: 10.20517/mrr.2022.14.
[12]	Bengmark S. Synbiotics to strengthen gut barrier function and reduce morbidity in critically ill patients[J]. Clin Nutr, 2004, 23(4): 441-445. DOI: 10.1016/j.clnu.2004.01.005.
[13]	Azuma H, Mishima S, Oda J, et al. Enteral supplementation enriched with glutamine, fiber, and oligosaccharide prevents gut translocation in a bacterial overgrowth model[J]. J Trauma, 2009, 66(1): 110-114. DOI: 10.1097/TA.0b013e318193109b.
[14]	Satoh H, Hara T, Murakawa D, et al. Soluble dietary fiber protects against nonsteroidal anti-inflammatory drug-induced damage to the small intestine in cats[J]. Dig Dis Sci, 2010, 55(5): 1264-1271. DOI: 10.1007/s10620-009-0893-2.
[15]	张艳军.不同膳食纤维对重型颅脑损伤患者肠屏障的影响[J].河北医科大学学报, 2010, 31(5): 570-572. DOI: 10.3969/j.issn.1007-3205.2010.05.027.
[16]	曹敏,雷光鸿,米运宏,等.低聚果糖的研究进展[J].轻工科技, 2017, 33(3): 19-21+26.
[17]	Park JS, Lee EJ, Lee JC, et al. Anti-inflammatory effects of short chain fatty acids in IFN-gamma-stimulated RAW 264.7 murine macrophage cells: involvement of NF-kappaB and ERK signaling pathways[J]. Int Immunopharmacol, 2007, 7(1): 70-77. DOI: 10.1016/j.intimp.2006.08.015.
[18]	Vinolo MA, Rodrigues HG, Hatanaka E, et al. Suppressive effect of short-chain fatty acids on production of proinflammatory mediators by neutrophils[J]. J Nutr Biochem, 2011, 22(9): 849-855. DOI: 10.1016/j.jnutbio.2010.07.009.
[19]	McDole JR, Wheeler LW, McDonald KG, et al. Goblet cells deliver luminal antigen to CD103+ dendritic cells in the small intestine[J]. Nature, 2012, 483(7389): 345-349. DOI: 10.1038/nature10863.
[20]	Lelouard H, Fallet M, de Bovis B, et al. Peyer's patch dendritic cells sample antigens by extending dendrites through m cell-specific transcellular pores[J]. Gastroenterology, 2012, 142(3): 592-601.e593. DOI: 10.1053/j.gastro.2011.11.039.
[21]	Edelman M, Wang Q,Ahnen R, et al. The dose response effects of partially hydrolyzed guar gum on gut microbiome of healthy adults[J]. Applied Microbiology, 2024, 4(2): 720-730. DOI: 10.3390/applmicrobiol4020049.
[22]	Kapoor MP, Koido M, Kawaguchi M, et al. Lifestyle related changes with partially hydrolyzed guar gum dietary fiber in healthy athlete individuals—A randomized, double-blind, crossover, placebo-controlled gut microbiome clinical study[J]. J Funct Foods, 2020, 72: 104067. DOI: 10.1016/j.jff.2020.104067.
[23]	Rosli D, Shahar S, Manaf ZA, et al. Randomized controlled trial on the effect of partially hydrolyzed guar gum supplementation on diarrhea frequency and gut microbiome count among pelvic radiation patients[J]. JPEN J Parenter Enteral Nutr, 2021, 45(2): 277-286. DOI: 10.1002/jpen.1987.
[24]	Zhou X, Willems RJL, Friedrich AW, et al. Enterococcus faecium: from microbiological insights to practical recommendations for infection control and diagnostics[J]. Antimicrob Resist Infect Control, 2020, 9(1): 130. DOI: 10.1186/s13756-020-00770-1.
[25]	Xu W, Zou K, Zhan Y, et al. Enterococcus faecium GEFA01 alleviates hypercholesterolemia by promoting reverse cholesterol transportation via modulating the gut microbiota-SCFA axis[J]. Frontiers in Nutrition, 2022, 9: 1020734. DOI: 10.3389/fnut.2022.1020734..
[26]	Gallardo-Becerra L, Cornejo-Granados F, García-López R, et al. Metatranscriptomic analysis to define the Secrebiome, and 16S rRNA profiling of the gut microbiome in obesity and metabolic syndrome of Mexican children[J]. Microb Cell Fact, 2020, 19(1): 61. DOI: 10.1186/s12934-020-01319-y.
[27]	Shapiro J, Cohen NA, Shalev V, et al. Psoriatic patients have a distinct structural and functional fecal microbiota compared with controls[J]. J Dermatol, 2019, 46(7): 595-603. DOI: 10.1111/1346-8138.14933.
[28]	Li M, Liu S, Wang M, et al. Gut microbiota dysbiosis associated with bile acid metabolism in neonatal cholestasis disease[J]. Sci Rep, 2020, 10(1): 7686. DOI: 10.1038/s41598-020-64728-4.
[29]	Moreno-Arrones OM, Serrano-Villar S, Perez-Brocal V, et al. Analysis of the gut microbiota in alopecia areata: identification of bacterial biomarkers[J]. J Eur Acad Dermatol Venereol, 2020, 34(2): 400-405. DOI: 10.1111/jdv.15885.
[30]	Huang R, Li F, Zhou Y, et al. Metagenome-wide association study of the alterations in the intestinal microbiome composition of ankylosing spondylitis patients and the effect of traditional and herbal treatment[J]. J Med Microbiol, 2020, 69(6): 797-805. DOI: 10.1099/jmm.0.001107.
[31]	Qiao S, Liu C, Sun L, et al. Gut parabacteroides merdae protects against cardiovascular damage by enhancing branched-chain amino acid catabolism[J]. Nat Metab, 2022, 4(10): 1271-1286. DOI: 10.1038/s42255-022-00649-y.
[32]	Zhu J, Yin J, Chen J, et al. Integrative analysis with microbial modelling and machine learning uncovers potential alleviators for ulcerative colitis[J]. Gut Microbes, 2024, 16(1): 2336877. DOI: 10.1080/19490976.2024.2336877.
[33]	Yan Q, Gu Y, Li X, et al. Alterations of the gut microbiome in hypertension[J]. Front Cell Infect Microbiol, 2017, 7: 381. DOI: 10.3389/fcimb.2017.00381.
[34]	Chu W, Han Q, Xu J, et al. Metagenomic analysis identified microbiome alterations and pathological association between intestinal microbiota and polycystic ovary syndrome[J]. Fertil Steril, 2020, 113(6): 1286-1298.e4. DOI: 10.1016/j.fertnstert.2020.01.027.
[35]	龚凌霄,刘飞越,方芳,等.膳食纤维在胃肠道功能紊乱综合征中的作用研究进展[J].中国食品学报, 2023, 23(6): 385-401. DOI: 10.16429/j.1009-7848.2023.06.038.
[36]	刘畅,吴慧,范恒.饮食疗法通过肠道菌群治疗溃疡性结肠炎的机制研究进展[J].世界华人消化杂志, 2021, 29(3): 146-151. DOI: 10.11569/wcjd.v29.i3.146.
[37]	David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome[J]. Nature, 2014, 505(7484): 559-563. DOI: 10.1038/nature12820.
[38]	Holscher HD. Dietary fiber and prebiotics and the gastrointestinal microbiota[J]. Gut Microbes, 2017, 8(2): 172-184. DOI: 10.1080/19490976.2017.1290756.

项目	SDF组（n=18）	Non-SDF组（n=24）	χ²/t/Z值	P值
性别[例（%）]			0	1.000
男	12（66.67）	16（66.67）
女	6（33.33）	8（33.33）
年龄（岁，±s）	56.56±15.52	58.13±11.98	-0.370	0.713
BMI（kg/m²，±s）	23.64±2.66	24.98±3.35	-1.403	0.168
出血原因[例（%）]			0.203	0.653
高血压脑出血	11（61.11）	13（54.17）
脑外伤	7（38.89）	11（45.83）
脑疝[例（%）]	4（22.22）	3（12.50）	0.700	0.403
瞳孔散大[例（%）]			5.231	0.073
否	13（72.22）	22（91.67）
单侧	5（27.78）	1（4.17）
双侧	0（0.00）	1（4.17）
合并高血糖[例（%）]	5（27.78）	12（50.00）	2.108	0.147
使用抗生素[例（%）]			2.159	0.340
否	5（27.78）	3（12.50）
半合成青霉素	5（27.78）	11（45.83）
二/三代头孢	8（44.44）	10（41.67）
手术[例（%）]			1.378	0.502
否	3（16.67）	3（12.50）
钻孔	7（38.89）	6（25.00）
开颅	8（44.44）	15（62.50）
APACHEⅡ评分（分，±s）	13.33±4.85	12.25±3.80	0.812	0.422
NIHSS评分[分，M（Q1，Q3）]	27.5（23.8，29）	26.5（22.3，28）	-1.089	0.276
GCS评分[分，M（Q1，Q3）]	6（5，7.3）	6（5，8）	-0.286	0.775
平均每日热卡[kcal/（kg·d），M（Q1，Q3）]	1876（1799，2023）	1876（1463，2009）	-0.890	0.374

项目	SDF组（n=18）	Non-SDF组（n=24）	χ²/t/Z值	P值
性别[例（%）]			0	1.000
男	12（66.67）	16（66.67）
女	6（33.33）	8（33.33）
年龄（岁，±s）	56.56±15.52	58.13±11.98	-0.370	0.713
BMI（kg/m²，±s）	23.64±2.66	24.98±3.35	-1.403	0.168
出血原因[例（%）]			0.203	0.653
高血压脑出血	11（61.11）	13（54.17）
脑外伤	7（38.89）	11（45.83）
脑疝[例（%）]	4（22.22）	3（12.50）	0.700	0.403
瞳孔散大[例（%）]			5.231	0.073
否	13（72.22）	22（91.67）
单侧	5（27.78）	1（4.17）
双侧	0（0.00）	1（4.17）
合并高血糖[例（%）]	5（27.78）	12（50.00）	2.108	0.147
使用抗生素[例（%）]			2.159	0.340
否	5（27.78）	3（12.50）
半合成青霉素	5（27.78）	11（45.83）
二/三代头孢	8（44.44）	10（41.67）
手术[例（%）]			1.378	0.502
否	3（16.67）	3（12.50）
钻孔	7（38.89）	6（25.00）
开颅	8（44.44）	15（62.50）
APACHEⅡ评分（分，±s）	13.33±4.85	12.25±3.80	0.812	0.422
NIHSS评分[分，M（Q1，Q3）]	27.5（23.8，29）	26.5（22.3，28）	-1.089	0.276
GCS评分[分，M（Q1，Q3）]	6（5，7.3）	6（5，8）	-0.286	0.775
平均每日热卡[kcal/（kg·d），M（Q1，Q3）]	1876（1799，2023）	1876（1463，2009）	-0.890	0.374

菌种	临床指标	r值	P值
解糖普雷沃菌丰度	中性粒细胞计数	-0.38	0.013
	血小板	-0.36	0.019
	白细胞计数	-0.35	0.023
	淋巴细胞比例	0.31	0.043
狄氏副拟杆菌丰度	APACHEⅡ评分	0.41	0.007
	NIHSS评分	0.41	0.008
大肠埃希菌丰度	白细胞计数	0.38	0.013
	中性粒细胞计数	0.38	0.014
	淋巴细胞比例	-0.34	0.027
	降钙素原	-0.34	0.029
脆弱拟杆菌丰度	NIHSS评分	0.35	0.024
	APACHEⅡ评分	0.33	0.031

菌种	临床指标	r值	P值
解糖普雷沃菌丰度	中性粒细胞计数	-0.38	0.013
	血小板	-0.36	0.019
	白细胞计数	-0.35	0.023
	淋巴细胞比例	0.31	0.043
狄氏副拟杆菌丰度	APACHEⅡ评分	0.41	0.007
	NIHSS评分	0.41	0.008
大肠埃希菌丰度	白细胞计数	0.38	0.013
	中性粒细胞计数	0.38	0.014
	淋巴细胞比例	-0.34	0.027
	降钙素原	-0.34	0.029
脆弱拟杆菌丰度	NIHSS评分	0.35	0.024
	APACHEⅡ评分	0.33	0.031

Please choose a citation manager

Content to export