Evaluation of the impact of unhealthy nutrition on the intestinal microbiota, mitochondrial function and the formation of multiple organ metabolic syndrome, ways of correction

O. Oynotkinova, S. Matskeplishvili, T. Demidova, A. Ametov, O. Maslennikova, V. Larina, A. Moskalev, S. Gusarenko, V. M. Kuraeva, A. V. Kazbekova
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Abstract

BACKGROUND: The problem of metabolic syndrome is considered a demographic catastrophe. According to WHO experts,«by 2025, the prevalence of metabolic syndrome (MS) in the world will amount to more than 300 million people, and in the next 25 years it is expected to increase by 50%.» The pathophysiological mechanisms of MS formation and the role of unhealthy diet on the development of intestinal dysbiosis, mitochondrial insufficiency remain unclear.AIM: To study the effect of unhealthy diet on the state of the intestinal microbiota and the development of metabolicmitochondrial insufficiency in the formation of a multi-organ metabolic syndrome, evaluation of ways of correction.MATERIALS AND METHODS: Clinical picture assessment, anthropometric data (body mass index), laboratory results (glucose, cholesterol and fractions) were carried out in patients with MS, triglycerides, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, lipid peroxidation indicators: malondialdehyde, diene conjugates, schiff bases, hydroperoxides, catalase, superoxide dismutase, succinate dehydrogenase (ASDH), α-glycerophosphate dehydrogenase (α-AGFDH). Hemorheological parameters were evaluated by the apparent viscosity of blood, the yield strength, the aggregation coefficient of erythrocytes and platelets. The microbiota and microbiome of the intestine were evaluated by species, strain composition and the level of metabolites-propionic, butyric, acetic acid, lipopolysaccharides, peptidoglycans. A questionnaire was conducted to study the nature of nutrition.RESULTS: The study included 128 patients with MS and 25 healthy individuals. According to medical outpatient records from anamnesis, questioning of each patient, complaints and clinical picture, 26.2% of patients had type 2 diabetes, 3.74% of men had erectile dysfunction, 7.5% of women had polycystic ovaries, 15.1% had night apnea syndrome, 8.7% hyperuricemic syndrome, 96.5% of patients had metabolic fatty liver steatosis. According to the results of the survey, it was revealed that 99.8% of patients adhered to an unhealthy and unbalanced, high-calorie diet, 46.4% of patients had a low level of physical activity, 48.7% had an average. The revealed disorders of lipid, carbohydrate metabolism, microbiota and intestinal microbiome were associated with increased lipid peroxidation, decreased levels of antioxidant defense enzymes, indicators reflecting mitochondrial function against the background of hemorheological disorders.CONCLUSION: In multi-organ MS, unhealthy diet can be considered as a targeted risk factor triggering pathophysiological mechanisms at the level of the intestinal microbiota, followed by a cascade of metabolic disorders in the form of activation of lipid peroxidation with inhibition of antioxidant defense enzymes, the development of multi-organ mitochondrial insufficiency and the development of latent hemorheological syndrome. The revealed metabolic complex obviously constitutes a multiorgan morphological cluster underlying the development of multi-organ metabolic syndrome. Based on the identified disorders, pathogenetically justified correction of MS should include a balanced diet with mitochondrial protective therapy.
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评估不健康营养对肠道微生物群、线粒体功能和多器官代谢综合征形成的影响,纠正方法
背景:代谢综合征的问题被认为是一场人口灾难。据世界卫生组织专家称,到2025年,全球代谢综合征(MS)的发病率将超过3亿人,预计在未来25年内将增长50%。»MS形成的病理生理机制以及不健康饮食在肠道微生态失调、线粒体功能不全发展中的作用尚不清楚。目的:研究不健康饮食对多器官代谢综合征形成过程中肠道微生物群状态和代谢线粒体功能不全发展的影响,评价纠正方法。材料和方法:对MS患者进行临床图片评估、人体测量数据(体重指数)、实验室结果(葡萄糖、胆固醇和组分)、甘油三酯、天冬氨酸转氨酶、丙氨酸转氨酶、C反应蛋白、脂质过氧化指标:丙二醛、二烯偶联物、席夫碱、过氧化氢酶,超氧化物歧化酶、琥珀酸脱氢酶(ASDH)、α-甘油磷酸脱氢酶(α-AGFDH)。通过血液的表观粘度、屈服强度、红细胞和血小板的聚集系数来评估血液流变学参数。肠道的微生物群和微生物组通过物种、菌株组成和代谢产物丙酸、丁酸、乙酸、脂多糖和肽聚糖的水平进行评估。进行了一项问卷调查,以研究营养的性质。结果:本研究包括128名MS患者和25名健康人。根据门诊病历、对每位患者的询问、投诉和临床表现,26.2%的患者患有2型糖尿病,3.74%的男性患有勃起功能障碍,7.5%的女性患有多囊卵巢,15.1%患有夜间呼吸暂停综合征,8.7%患有高尿酸血症综合征,96.5%的患者患有代谢性脂肪肝脂肪变性。根据调查结果,99.8%的患者坚持不健康、不平衡、高热量的饮食,46.4%的患者体力活动水平较低,48.7%的患者平均水平较低。所揭示的脂质、碳水化合物代谢、微生物群和肠道微生物组的紊乱与脂质过氧化增加、抗氧化防御酶水平降低有关,这些指标反映了血液流变学紊乱背景下的线粒体功能。结论:在多器官多发性硬化症中,不健康饮食可被视为在肠道微生物群水平上触发病理生理机制的靶向风险因素,随后以激活脂质过氧化和抑制抗氧化酶的形式出现一系列代谢紊乱,多器官线粒体功能不全的发展和潜在血液流变学综合征的发展。所揭示的代谢复合体显然构成了多器官代谢综合征发展的多器官形态簇。根据已确定的疾病,病因合理的多发性硬化症矫正应包括平衡饮食和线粒体保护性治疗。
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Obesity and Metabolism-Milan
Obesity and Metabolism-Milan 医学-内分泌学与代谢
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