Zhang, X, Cai, W, Liao, S et al. · Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2021 · DOI
This study compared the gut bacteria of 75 nursing staff members with sub-health status (feeling unwell without a specific diagnosis) to 75 healthy staff members. Researchers found that people with sub-health status had a different balance of gut bacteria compared to healthy people, with greater diversity in bacterial types but an overall imbalance in their gut microbial community.
Gut microbiota dysbiosis has been implicated in chronic illness and fatigue states. Understanding whether individuals with sub-health status—a condition characterized by unexplained symptoms similar to those in ME/CFS—have distinct microbial signatures could inform future research into whether microbiome modifications might benefit ME/CFS patients experiencing similar symptom profiles.
This study does not establish causation—it is unclear whether the altered microbiota composition causes sub-health status or results from it. The study examines only nursing staff, limiting generalizability to other populations. Additionally, sub-health status is not ME/CFS, and findings may not directly apply to clinically defined ME/CFS patients.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Zhang, X, Cai, W, Liao, S, He, X, Yang, Q, Bai, Y, et al. (2021). [Individuals with sub-health status have obviously unbalanced structure of the intestinal flora: analysis of 150 nursing staff members].. Nan fang yi ke da xue xue bao = Journal of Southern Medical University. https://doi.org/10.12122/j.issn.1673-4254.2021.12.17
BibTeX
@article{mecfsatlas-zhang-2021-individuals-sub,
author = {Zhang, X and Cai, W and Liao, S and He, X and Yang, Q and Bai, Y and Ruan, W},
title = {[Individuals with sub-health status have obviously unbalanced structure of the intestinal flora: analysis of 150 nursing staff members].},
journal = {Nan fang yi ke da xue xue bao = Journal of Southern Medical University},
year = {2021},
doi = {10.12122/j.issn.1673-4254.2021.12.17},
note = {PubMed: 35012921},
url = {https://www.mecfsatlas.com/evidence/zhang-2021-individuals-sub},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/zhang-2021-individuals-sub
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