Vaginal microecological characterization of women of childbearing age at different altitudes: a multi-omics exploration.

BACKGROUND: Reproductive tract diseases have become a serious public health problem threatening women's health. Vaginal microecological balance in women of childbearing age is essential for the maintenance of reproductive health, and different environmental conditions may have an impact on the composition of the vaginal microbial community and its metabolites. This is particularly true at different altitudes. Changes in environmental factors with increasing altitude may lead to vaginal microecological imbalances that increase the risk of reproductive tract infections and other gynecological diseases. Therefore, it is important to study vaginal microbial communities and metabolites in women of reproductive age at different altitudes. In this study, 16 S rDNA sequencing and non-targeted metabolomics of vaginal secretions from healthy women of childbearing age at different altitudes were performed to analyze the composition of vaginal flora and metabolites of normal women of childbearing age at different altitudes, with the aim of providing new ideas for the prevention, diagnosis and treatment of diseases caused by vaginal microecological imbalance in women of childbearing age. METHODS: General clinical data and vaginal secretions of a total of 60 healthy women of childbearing age were collected from four regions, namely, the low altitude group (8 m above sea level), the middle altitude group (2,000 m above sea level), the middle-high altitude group (2,800 m above sea level), and the same as the high altitude group (4,000 m above sea level), and were analyzed by sequencing of the V3-V4 region of the 16 S rDNA and untargeted metabolomics sequencing. RESULTS: 16 S rDNA sequencing can be used to comprehensively analyze the reproductive tract flora of women of childbearing age at different altitudes; the vaginal flora of normal women of childbearing age is dominated by the phylum Thick-walled Bacteria and Lactobacillus spp. The α-diversity of the vaginal flora increases with the elevation of altitude but there is no statistically significant difference; with the elevation of altitude, the percentage of the specialized anaerobic flora in the vagina is higher among the genera of Porphyromonas, Anaerobic Coccidia, and Peptostreptococcus. anaerobic increased in the vagina. Non-targeted metabolomics analysis revealed that there were differences in vaginal metabolites among women of childbearing age at different altitudes, with energy metabolism and nutrient metabolism being the main ones. Analysis of the four groups of differential metabolites showed that Ectoine, Thiamine, Taurine, D-glucono-1,5-lactone, 2-oxoadipic acid and N-Acetylserotonin differed significantly in the distribution of the four groups and were significantly elevated in the vaginas of women at high altitude. CONCLUSION: With the increase of altitude, the diversity of vaginal flora of women of childbearing age increased, and at the same time, there were differences in vaginal metabolites at different altitudes, which were hypothesized to be related to factors such as hypoxia, high altitude, and differences in hygiene habits in the plateau. The relationship between this and high altitude and reproductive tract diseases will be further explored in the future to provide theoretical guidance for improving the reproductive health of women of childbearing age in highland areas.