{
  "abstract": "Background Traditional Chinese Medicine (TCM) proposes that individuals may experience suboptimal health even in the absence of overt disease. Based on physiological patterns and symptoms, individuals are classified into a balanced constitution (NBC) or eight unbalanced body constitution types. Emerging studies suggest that gut microbiome composition may relate to these constitution-associated physiological patterns. However, most studies classify individuals based on a primary constitution despite the frequent occurrence of multi-constitution profiles, which may confound microbiome associations. This study aimed to characterize the distribution of single TCM body constitution types in a healthy Singapore adult population and examine their associations with gut microbiome composition.Methods Healthy community-dwelling adults (n=800), aged ≥21 years, without chronic disease, gastrointestinal disorders, smoking history, or recent antibiotic use were recruited through AMILI’s ‘Poop Saves Lives’ campaign (2010–2024) with IRB approval (2020/0501). TCM body constitution was assessed using the validated Constitution in Chinese Medicine Questionnaire, restricting analysis to individuals with a single constitution. Stool microbial DNA underwent shotgun metagenomic sequencing and taxonomic profiling using the BioBakery pipeline. Alpha and beta diversity and differential abundance analysis (MaAsLin2) were performed in R comparing each unbalanced type against NBC while adjusting for age, BMI, gender, and race.Results Among 800 healthy participants, 61% exhibited a single TCM body constitution, with NBC being most prevalent. Gut microbial community structure differed modestly across constitution types based on Bray–Curtis β-diversity (PERMANOVA p=0.045), whereas α-diversity indices did not differ significantly. After adjustment for demographic covariates, differential abundance analysis identified several constitution-associated taxa (IDDF2026-ABS-0289 Figure 1). Klebsiella (including Klebsiella pneumoniae) and Megasphaera sp. NM10 were enriched in Qi-deficiency constitution (QIDC), while Schaalia spp. were enriched in Qi-stagnation constitution (QSBC) (q<0.05). In contrast, blood-stasis constitution (BSBC) showed reduced abundance of the butyrate-producing bacterium Agathobaculum, including Agathobaculum butyriciproducens (q<0.05). Hierarchical clustering of MaAsLin2 effect-size profiles suggested three constitution-related differential abundance patterns, with QIDC clustering closely with QSBC, while BSBC exhibited a distinct microbial profile. Conclusions In conclusion, TCM body constitution types showed modest differences in gut microbiome composition among healthy adults, suggesting a potential microbial basis for constitution-related physiological variation.Abstract IDDF2026-ABS-0289 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Nanyang Technological University, Singapore"
      ],
      "name": "Kai-Yee Toh"
    },
    {
      "affiliations": [
        "Nanyang Technological University, Singapore"
      ],
      "name": "Sunny Wong"
    },
    {
      "affiliations": [
        "Nanyang Technological University, Singapore"
      ],
      "name": "Linda Zhong"
    },
    {
      "affiliations": [
        "AMILI Pte Ltd, Singapore"
      ],
      "name": "Jeremy Lim"
    }
  ],
  "title": "IDDF2026-ABS-0289 Gut microbiome variation across traditional chinese medicine body constitutions in a healthy singapore population",
  "uid": "8877ef28-4227-52df-8a7a-5a0b55d5a974"
}