Insights Into the Role of the Microbiome in Obesity and Type 2 Diabetes
Insights Into the Role of the Microbiome in Obesity and Type 2 Diabetes
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DOI：
10.2337/dc14-0769
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发表时间：
2015-01-01
期刊：
影响因子：
16.2
通讯作者：
Nieuwdorp, Max
中科院分区：
文献类型：
--
作者：
Hartstra, Annick V.;Bouter, Kristien E. C.;Nieuwdorp, Max
肥胖和2型糖尿病（T2DM）的全球患病率继续以惊人的速度上升。最近，肠道微生物组在这些代谢紊乱中的潜在作用已被确定。肥胖与肠道微生物群组成的变化有关，肥胖的微生物群似乎更有效地从饮食中获取能量。在患有代谢综合征的男性中进行瘦男性供体粪便微生物群移植（FMT）导致胰岛素敏感性显著改善，同时肠道微生物多样性增加，包括产丁酸盐细菌菌株的明显增加。肠道微生物群组成的这种差异可能作为高危患者发生T2DM的早期诊断标志物。丁酸盐等肠道微生物的产物可通过增强线粒体活性、预防代谢性内毒素血症以及通过不同的基因表达和激素调节途径激活肠道新生来诱导有益的代谢效应。未来的研究应该集中在细菌产物（如丁酸盐）是否与产生它的肠道细菌具有相同的作用，以便最终为肥胖和T2DM的更成功的干预措施铺平道路。目前可用技术的快速发展，包括使用粪便移植，已经显示出有希望的结果，因此未来有希望开发基于微生物群的新疗法。
The worldwide prevalence of obesity and type 2 diabetes mellitus (T2DM) continues to rise at an alarming pace. Recently the potential role of the gut microbiome in these metabolic disorders has been identified. Obesity is associated with changes in the composition of the intestinal microbiota, and the obese microbiome seems to be more efficient in harvesting energy from the diet. Lean male donor fecal microbiota transplantation (FMT) in males with metabolic syndrome resulted in a significant improvement in insulin sensitivity in conjunction with an increased intestinal microbial diversity, including a distinct increase in butyrate-producing bacterial strains. Such differences in gut microbiota composition might function as early diagnostic markers for the development of T2DM in high-risk patients. Products of intestinal microbes such as butyrate may induce beneficial metabolic effects through enhancement of mitochondrial activity, prevention of metabolic endotoxemia, and activation of intestinal gluconeogenesis via different routes of gene expression and hormone regulation. Future research should focus on whether bacterial products (like butyrate) have the same effects as the intestinal bacteria that produce it, in order to ultimately pave the way for more successful interventions for obesity and T2DM. The rapid development of the currently available techniques, including use of fecal transplantations, has already shown promising results, so there is hope for novel therapies based on the microbiota in the future.