衰弱症干预的新角度:营养-肠道菌群-衰弱轴

A new perspective of frailty intervention:nutrition-gut flora-frailty axis

在全球人口老龄化背景下,衰弱症作为老年医学重要的多维概念,其早期诊断和干预已成为研究者关注的主要方向。能量和营养的低摄入在推动衰弱症进展中的作用不容忽视。肠道菌群通过双向调节宿主和肠菌的营养代谢、信号传导,以及对宿主多种器官的直接生物化学作用,不仅参与代谢疾病的发病机制,而且帮助营养策略发挥干预作用。本综述从骨骼肌和免疫角度总结了肠道菌群和食源性代谢物参与营养-衰弱相互作用的文献进展。现有文献提示短链脂肪酸和氨基酸等食源性肠道菌群代谢物作为宿主受体的配体参与调节肌肉、认知和免疫功能,进而影响宿主的衰弱进程,即支持“营养-肠道菌群-衰弱轴”的存在。随着肠道菌谱分析和代谢组学等技术在该领域的深入应用,营养-肠道菌群将为衰弱症的早期发现和干预提供新颖、经济和有效的个体化手段。

In the context of global population aging,early diagnosis and intervention of frailty,an important multidimensional concept of geriatrics,have become the main focus of researchers.The role of low energy and nutrient intake in promoting the progression of frailty has been well recognized.Through interactive host-microbiota metabolism,signaling,and direct chemical effects on the host's various organs,intestinal microbes not only participate in the pathogenesis of metabolic diseases,but also help nutritional strategies to exert intervention effects.This review summarizes the progress on the involvement of gut microbiota and food-derived metabolites in the nutrition-frailty interaction from the perspective of skeletal muscle and immunity.Existing literature suggests that food-derived microbial metabolites,such as short-chain fatty acids and amino acids,act as ligands for host receptors to participate in the regulation of muscle,cognitive and immune functions,thereby affecting frailty progress in the elderlies,that is,supporting the existence of nutrition-intestinal flora-frailty axis.With the in-depth application of intestinal bacteria profiling,metabolomics and other technologies in this field,nutrition-gut microbiota will provide novel,economical and effective individualized tools for early detection and intervention of frailty.