Gut microbiota profiling in patients with bone fragility fracture and severe osteoarthritis: A pilot study

Over the past decade, much attention has been directed towards the gut microbiota (GM) as a contributing factor to a wide range of diseases, especially in the aging population. In this study, we analyzed the GM of elderly patients with fragility fractures (age range 71-90 years, n = 13), and patients with severe osteoarthritis (age range 65-87 years, n = 11) using 16S rRNA amplicon sequencing of fecal samples and compared these profiles with those of healthy individuals (age range 65-100 years, n = 20). The aim was to improve understanding of GM alterations in skeletal diseases and to inform the future development of personalized therapeutic strategies. Analysis of microbial composition revealed that patients with skeletal disorders showed a dysbiotic GM profile, characterized by enrichment of Peptostreptococcaceae and Butyricicoccaceae, and other potentially pathogenic taxa, alongside depletion of healthy-associated, short-chain fatty acids (SCFA)-producing bacteria. Moreover, analysis of gut metabolic modules identified multiple functional differences between patients' groups and healthy controls, particularly in pathways related to SCFA production, amino acid metabolism, and energy metabolism. Overall, these findings demonstrate both shared and disease-specific dysbiotic signatures in the GM of elderly patients with fragility fractures or severe osteoarthritis compared with healthy individuals. Once validated in larger cohorts and supported by mechanistic studies, these results may pave the way for the development of novel GM-based intervention strategies for the management of skeletal diseases.