Sex-specific signatures of gut microbiota and systemic inflammation in patients with urolithiasis: a cross-sectional...

Urolithiasis is a globally prevalent disease with a distinct male predominance; however, the pathophysiological heterogeneity within diagnosed cohorts remains underexplored. This study delineates the sex-specific signatures of gut microbiota and systemic inflammation in urolithiasis patients to inform sex-stratified management.

This cross-sectional study enrolled 60 urolithiasis patients (40 males, 20 females). Systemic inflammatory cytokines were quantified via peripheral blood assays, and gut microbiota was profiled using 16S rRNA sequencing. Data were integrated to evaluate microbiome-immune-metabolic associations.

Baseline demographics and routine biochemical parameters were comparable between sexes. Male patients exhibited significantly elevated peripheral levels of pro-inflammatory cytokines, including IL-5, IL-17A, IFN-α, IL-12P70, and IFN-γ (P < 0.05). Beta-diversity analysis revealed no significant difference in the overall gut microbial community structures between sexes (P = 0.484). LEfSe analysis identified a significant enrichment of Akkermansia and Holdemanella in females, whereas Mogibacterium was notably enriched in males. Crucially, Mogibacterium abundance positively correlated with IL-17A and IL-12P70 levels (P < 0.05). Functional potential profiling indicated enhanced predicted capacities for secondary metabolite biosynthesis and lipid metabolism in the female cohort.

Our findings highlight significant sex-associated differences in gut microecology and systemic immune profiles within urolithiasis patients. The proinflammatory axis associated with male patients and the enhanced predicted metabolic capacities observed in female patients emphasize the potential value of exploring sex-tailored preventive and therapeutic interventions.