The human microbiome represents a new frontier in understanding the biology of human health. While epidemiology in this area is still in its infancy, its scope will likely expand dramatically over the coming years. To rise to the challenge, we argue that epidemiology should capitalize on its population perspective as a critical complement to molecular microbiome research, allowing for the illumination of contextual mechanisms that may vary more across populations rather than among individuals. We first briefly review current research on social context and the gut microbiome, focusing specifically on socioeconomic status (SES) and race/ethnicity. Next, we reflect on the current state of microbiome epidemiology through the lens of one specific area, the association of the gut microbiome and metabolic disorders. We identify key methodological shortcomings of current epidemiological research in this area, including extensive selection bias, the use of noncompositionally robust measures, and a lack of attention to social factors as confounders or effect modifiers. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

中文翻译：

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患病个体和患病（微生物）种群：流行病学和微生物组的挑战。

人类微生物组代表了理解人类健康生物学的新领域。虽然该领域的流行病学仍处于起步阶段，但其范围在未来几年可能会急剧扩大。为了迎接挑战，我们认为流行病学应该利用其人口视角作为对分子微生物组研究的重要补充，从而阐明可能在人群之间而非个体之间差异更大的背景机制。我们首先简要回顾当前关于社会背景和肠道微生物组的研究，特别关注社会经济地位 (SES) 和种族/民族。接下来，我们通过一个特定领域的镜头，即肠道微生物组与代谢紊乱的关联，反思微生物组流行病学的现状。我们确定了该领域当前流行病学研究的主要方法论缺陷，包括广泛的选择偏差、使用非组成稳健的措施，以及缺乏对社会因素作为混杂因素或影响调节因素的关注。《公共卫生年度回顾》第 41 卷的预计最终在线出版日期为 2020 年 4 月 1 日。请参阅 http://www.annualreviews.org/page/journal/pubdates 了解修订后的估计值。