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Subsequently, fecal samples from patients with GO, GD, and healthy donors were transplanted into antibiotic-treated pseudo-germ-free mice. Finally, the 48 patients with GO were randomly divided into two groups: one group received intravenous glucocorticoids (ivGC) and atorvastatin (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924), while the other group received ivGC only (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924), to observe the effects of atorvastatin on GO progression and its impact on gut microbiota.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with GO exhibit a distinct gut microbiota composition, particularly marked by increased levels of\n                      <jats:italic>Prevotella<\/jats:italic>\n                      and\n                      <jats:italic>Bacteroides<\/jats:italic>\n                      , compared to patients with GD and HC. Correlation analysis revealed a direct positive association between\n                      <jats:italic>Prevotella<\/jats:italic>\n                      and thyrotropin receptor antibody levels. Antibiotic-treated pseudo-germ-free mice that received fecal transplants from patients with GO exhibited a slower rate of weight gain, significant impairment of intestinal barrier integrity, and markedly increased levels of serum LBP and inflammatory factors. A combined treatment regimen of ivGCs and atorvastatin significantly reduced ocular clinical symptoms in patients with GO, including clinical activity score, exophthalmos, and intraocular pressure, while also promoting a healthier gut microbiota composition and a reduction in\n                      <jats:italic>Prevotella<\/jats:italic>\n                      levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Gut microbiota imbalance, particularly involving\n                      <jats:italic>Prevotella<\/jats:italic>\n                      , contributes to GO\u2019s development and progression. Atorvastatin may slow GO progression by correcting dysregulated gut microbiota, especially reducing\n                      <jats:italic>Prevotella<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40168-025-02219-2","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T17:34:28Z","timestamp":1767029668000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Modulation of gut microbiota in Graves\u2019 orbitopathy: Prevotella dominance and atorvastatin\u2019s impact"],"prefix":"10.1186","volume":"13","author":[{"given":"Danyu","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaonan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junpeng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinru","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueli","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiudan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenghong","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyuan","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibin","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"2219_CR1","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1111\/joim.13524","volume":"292","author":"L Bartalena","year":"2022","unstructured":"Bartalena L, Tanda ML. 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