肠道菌群与2型糖尿病微血管病变的相关性

Correlation between intestinal flora and microangiopathy in type 2 diabetes mellitus

2型糖尿病(T2DM)微血管病变是世界范围内最具热点的难题之一,其发病率和患病率不断上升。诸多研究证实肠道菌群与T2DM微血管病变之间存在复杂的关系。肠道菌群的改变导致胃肠道(GI)内环境紊乱,加快异常代谢产物生成、糖脂代谢紊乱、炎症反应,甚至胰岛素抵抗(IR)。短链脂肪酸(SCFAs)、脂多糖(LPS)、吲哚丙酸(IPA)和支链氨基酸(BCAAs)等通过不同代谢和免疫途径参与T2DM微血管病变的发生发展。本文旨在探讨肠道菌群与T2DM常见微血管病变(如肾病、周围神经病变、视网膜病变等)相关性及其免疫致病机制,以期为T2DM微血管病变的诊断治疗和科学研究提供方法。

Microangiopathy in type 2 diabetes mellitus is one of the hottest problems in the world,and its incidence and prevalence are increasing.Many studies have confirmed that there is a complex relationship between intestinal flora and T2DM microangiopathy.The changes in intestinal flora lead to disorders of the gastrointestinal environment,accelerate the production of abnormal metabolites,disorders of glucose and lipid metabolism,inflammation and even insulin resistance.short-chain fatty acids,lipopolysaccharides,indole propionic acids and branched chain amino acids are involved in the occurrence and development of T2DM microangiopathy through different metabolic and immune pathways.The purpose of this review was to explore the relationship between intestinal flora and common T2DM microangiopathy(nephropathy,peripheral neuropathy,retinopathy)and the underlying immunopathogenic mechanism in order to provide a method for the diagnosis,treatment and scientific research of T2DM microangiopathy.