肠道微生物群和糖尿病:开拓新的治疗前沿。

Rupendra Shakya, Ponnurengam Malliappan Sivakumar, Pranav Kumar Prabhakar
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摘要

糖尿病(DM)是一种以慢性高血糖为特征的复杂代谢疾病,对全球健康构成了重大挑战。常规治疗,如胰岛素治疗和生活方式改变,在解决糖尿病的多因素特性方面显示出有限的疗效。新证据表明,肠道微生物群是对代谢和免疫功能至关重要的多样化微生物群落,在代谢健康中起着关键作用。肠道菌群组成失调与胰岛素抵抗、肥胖和糖尿病有关。肠道菌群通过短链脂肪酸产生、肠道通透性调节和免疫系统相互作用等机制影响葡萄糖代谢,表明微生物健康与代谢之间存在双向关系。临床和实验研究表明,通过饮食干预(益生元、益生菌、合成菌)调节肠道微生物群可改善糖尿病患者的血糖控制和胰岛素敏感性。粪便微生物群移植(FMT)也显示出恢复健康肠道微生物群和减轻dm相关代谢紊乱的希望。然而,挑战仍然存在,包括由于个体微生物群的可变性和这些干预措施的未知长期影响而需要个性化治疗。未来的研究应侧重于阐明肠道微生物群影响代谢的机制,并完善个性化的方法来加强糖尿病的管理。
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Gut Microbiota and Diabetes: Pioneering New Treatment Frontiers.

Diabetes Mellitus (DM) is a complex metabolic disorder characterized by chronic hyperglycemia and poses significant global health challenges. Conventional treatments, such as insulin therapy and lifestyle modifications, have shown limited efficacy in addressing the multifactorial nature of DM. Emerging evidence suggests that gut microbiota, a diverse community of microorganisms critical for metabolism and immune function, plays a pivotal role in metabolic health. Dysbiosis, an imbalance in gut microbiota composition, has been linked to insulin resistance, obesity, and DM. Gut microbiota influences glucose metabolism through mechanisms, including short-chain fatty acid production, gut permeability regulation, and immune system interactions, indicating a bidirectional relationship between microbial health and metabolism. Clinical and experimental studies demonstrate that modulating gut microbiota through dietary interventions (prebiotics, probiotics, synbiotics) improves glycemic control and insulin sensitivity in DM patients. Fecal Microbiota Transplantation (FMT) has also shown promise in restoring healthy gut microbiota and alleviating DM-related metabolic disturbances. However, challenges remain, including the need for personalized treatments due to individual microbiota variability and the unknown long-term effects of these interventions. Future research should focus on elucidating the mechanisms by which gut microbiota influences metabolism and refining personalized approaches to enhance DM management.

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