{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:59:36Z","timestamp":1782889176551,"version":"3.54.5"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,31]],"date-time":"2022-12-31T00:00:00Z","timestamp":1672444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Capital Health Research and Development of Special Fund Program of China","award":["No.2020-2-5113"],"award-info":[{"award-number":["No.2020-2-5113"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Several recent studies have reported the relationship between atherosclerosis and gut microbial imbalance. Small intestinal bacterial overgrowth (SIBO) is one of the most common forms of gut microbiota imbalance, and studies have shown that SIBO plays an important role in human health. However, the relationship between SIBO and subclinical atheromatous plaques remains unclear. The aim of this study was to investigate the frequency of subclinical atheromatous plaques in patients with SIBO and to explore the association between these two conditions. Methods: A total of 411 eligible subjects were included in this study. The lactulose hydrogen-methane breath test was used to diagnose SIBO, and ultrasound examinations of the carotid, abdominal aorta and lower extremity arteries were performed in all subjects to assess the presence of plaques. Results: Plaques were more common in the SIBO-positive group than in the SIBO-negative group (abdominal aorta, 74.2% vs. 38.8%, p &lt; 0.01; carotid arteries, 71.7% vs. 52.3, p &lt; 0.01; lower extremity arteries, 73.4% vs. 57.6%, p &lt; 0.01). After adjusting for traditional confounders, compared to the SIBO-negative population, the SIBO-positive population had, respectively, OR = 4.18 (95% CI = 2.56\u20136.80, p &lt; 0.001), OR = 1.93 (95% CI = 1.23\u20133.02, p = 0.004), OR = 1.81 (95% CI = 1.14\u20132.88, p = 0.011) and OR = 5.42 (95% CI = 2.78\u201310.58, p &lt; 0.001) for abdominal, carotid, lower extremity and any-territory plaque presence. Conclusion: SIBO was found to be associated with subclinical atheromatous plaques, and the mechanism of this association warrants further exploration.<\/jats:p>","DOI":"10.3390\/jcm12010314","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T03:00:59Z","timestamp":1672628459000},"page":"314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association between Small Intestinal Bacterial Overgrowth and Subclinical Atheromatous Plaques"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-3447","authenticated-orcid":false,"given":"Changhao","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou 510006, China"},{"name":"Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3224-5881","authenticated-orcid":false,"given":"Guangxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China"},{"name":"The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Xian","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou 510006, China"},{"name":"Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, School of Medicine, South China University of Technology, Guangzhou 510006, China"},{"name":"Department of Gastroenterology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing 100048, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019: Update From the GBD 2019 Study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1016\/j.jacc.2019.08.012","article-title":"From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events: JACC State-of-the-Art Review","volume":"74","author":"Ahmadi","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.lfs.2018.10.063","article-title":"Interaction between gut microbiome and cardiovascular disease","volume":"214","author":"Peng","year":"2018","journal-title":"Life Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1161\/CIRCRESAHA.117.309715","article-title":"Gut Microbiota in Cardiovascular Health and Disease","volume":"120","author":"Tang","year":"2017","journal-title":"Circ. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1038\/s41467-017-00900-1","article-title":"The gut microbiome in atherosclerotic cardiovascular disease","volume":"8","author":"Jie","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5009\/gnl16126","article-title":"Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy","volume":"11","author":"Ghoshal","year":"2017","journal-title":"Gut. Liver"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"664","DOI":"10.3389\/fpsyt.2020.00664","article-title":"Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome\u2014An Update","volume":"11","author":"Takakura","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5583","DOI":"10.3390\/nu6125583","article-title":"The Role of Intestinal Bacteria Overgrowth in Obesity-Related Nonalcoholic Fatty Liver Disease","volume":"6","author":"Ferolla","year":"2014","journal-title":"Nutrients"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e015292","DOI":"10.1161\/JAHA.119.015292","article-title":"Association of Small Intestinal Bacterial Overgrowth With Heart Failure and Its Prediction for Short-Term Outcomes","volume":"10","author":"Song","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"165","DOI":"10.14309\/ajg.0000000000000501","article-title":"ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth","volume":"115","author":"Pimentel","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/ajg.2017.46","article-title":"Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus","volume":"112","author":"Rezaie","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1159\/000343145","article-title":"Mannheim Carotid Intima-Media Thickness and Plaque Consensus (2004\u20132006\u20132011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th european stroke conferences, mannheim, germany, 2004, brussels, belgium, 2006, and hamburg, germany, 2011","volume":"34","author":"Touboul","year":"2012","journal-title":"Cerebrovasc. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Sanchez-Rodriguez, E., Egea-Zorrilla, A., Plaza-D\u00edaz, J., Arag\u00f3n-Vela, J., Mu\u00f1oz-Quezada, S., Tercedor-S\u00e1nchez, L., and Abadia-Molina, F. (2020). The Gut Microbiota and Its Implication in the Development of Atherosclerosis and Related Cardiovascular Diseases. Nutrients, 12.","DOI":"10.3390\/nu12030605"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1038\/s12276-022-00728-w","article-title":"Fecal microbiota transplantation ameliorates atherosclerosis in mice with C1q\/TNF-related protein 9 genetic deficiency","volume":"54","author":"Kim","year":"2022","journal-title":"Exp. Mol. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1161\/CIRCRESAHA.118.313234","article-title":"A Proinflammatory Gut Microbiota Increases Systemic Inflammation and Accelerates Atherosclerosis","volume":"124","author":"Brandsma","year":"2019","journal-title":"Circ. Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Pieczynska, M.D., Yang, Y., Petrykowski, S., Horbanczuk, O.K., Atanasov, A.G., and Horbanczuk, J.O. (2020). Gut Microbiota and Its Metabolites in Atherosclerosis Development. Molecules, 25.","DOI":"10.3390\/molecules25030594"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/nature09922","article-title":"Gut Flora Metabolism of Phosphatidylcholine Promotes Cardiovascular Disease","volume":"472","author":"Wang","year":"2011","journal-title":"Nature"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/apm.13038","article-title":"Gut microbiota in atherosclerosis: Focus on trimethylamine N-oxide","volume":"128","author":"Zhu","year":"2020","journal-title":"APMIS"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6110","DOI":"10.1038\/s41598-021-85527-5","article-title":"Bacterial metabolites trimethylamine N-oxide and butyrate as surrogates of small intestinal bacterial overgrowth in patients with a recent decompensated heart failure","volume":"11","author":"Mollar","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.3748\/wjg.v23.i7.1241","article-title":"Subclinical atherosclerosis is linked to small intestinal bacterial overgrowth via vitamin K2-dependent mechanisms","volume":"23","author":"Ponziani","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3389\/fcvm.2019.00041","article-title":"Pulse Wave Velocity in Atherosclerosis","volume":"6","author":"Kim","year":"2019","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_22","first-page":"111","article-title":"AHA Conference Proceedings. Prevention conference V: Beyond secondary prevention: Identifying the high-risk patient for primary prevention: Executive summary","volume":"101","author":"Smith","year":"2000","journal-title":"Am. Heart Assoc. Circ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1093\/ehjci\/jex239","article-title":"Carotid plaque thickness and carotid plaque burden predict future cardiovascular events in asymptomatic adult Americans","volume":"19","author":"Sillesen","year":"2018","journal-title":"Eur. Hear. J. Cardiovasc. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.atherosclerosis.2011.06.044","article-title":"Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: A meta-analysis","volume":"220","author":"Inaba","year":"2012","journal-title":"Atherosclerosis"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1111\/j.1365-2036.2011.04625.x","article-title":"Clinical predictors of small intestinal bacterial overgrowth by duodenal aspirate culture","volume":"33","author":"Choung","year":"2011","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1586\/17474124.2016.1110017","article-title":"Diagnosis and treatment of small intestinal bacterial overgrowth","volume":"10","author":"Ponziani","year":"2016","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1053\/j.gastro.2020.06.090","article-title":"AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review","volume":"159","author":"Quigley","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1002\/hep.22848","article-title":"Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease","volume":"49","author":"Miele","year":"2009","journal-title":"Hepatology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S78","DOI":"10.1053\/j.gastro.2005.11.046","article-title":"Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics, and Probiotics","volume":"130","author":"Quigley","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1177\/0884533613485882","article-title":"Diagnosis and Management of Small Intestinal Bacterial Overgrowth","volume":"28","author":"Bohm","year":"2013","journal-title":"Nutr. Clin. Pract."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1093\/oxfordjournals.aje.a008828","article-title":"Homocysteine Metabolism and Risk of Myocardial Infarction: Relation with Vitamins B6, B12, and Folate","volume":"143","author":"Verhoef","year":"1996","journal-title":"Am. J. Epidemiol."},{"key":"ref_32","first-page":"730","article-title":"High-Dose B Vitamin Supplementation and Progression of Subclinical Atherosclerosis: A Randomized Controlled Trial","volume":"40","author":"Hodis","year":"2009","journal-title":"J. Vasc. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1016\/j.cgh.2021.09.035","article-title":"Distinctive Clinical Correlates of Small Intestinal Bacterial Overgrowth with Methanogens","volume":"20","author":"Madigan","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/314\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:48:56Z","timestamp":1760147336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,31]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010314"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010314","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,31]]}}}