肠道菌群失调与糖尿病相关性的研究进展

Research progress on the correlation between gut microbiota disorder and diabetes mellitus

糖尿病为常见的慢性代谢性疾病之一,具有明显的遗传易感性。患者长期处于高血糖的状态易并发多系统损伤,有着较高的致残率和病死率,严重威胁到患者的健康。近年来,大量研究表明糖尿病的发生发展与遗传、环境等因素有关之外,还与肠道菌群失调有关。糖尿病患者的肠道菌群有着不同程度的失调,其中厚壁菌门与拟杆菌门的丰度变化尤为显著。肠道菌群失调可通过改变宿主肠黏膜屏障、影响短链脂肪酸合成、胆汁酸代谢异常等机制使患者胰岛素敏感性降低、能量代谢异常最终导致糖尿病。基于肠道菌群治疗糖尿病也是目前内分泌领域研究热点,用益生菌、粪便菌群移植、减肥手术等方式均能调节肠道菌群,对糖尿病起到治疗效果,为糖尿病患者带来了新的希望。

Diabetes mellitus is one of the common chronic metabolic diseases with obvious genetic susceptibility.Patients in the state of hyperglycemia for a long time are prone to multiple system damage,with a high disability rate and fatality rate,which seriously threatens the health of patients.In recent years,a large number of studies have shown that diabetes is not only related to genetic,environmental and other factors,but also related to the imbalance of gut microbiota.The gut microbiota of diabetic has different degrees of imbalance,especially the abundance of Firmicutes and Bacteroides.The imbalance of gut microbiota can reduce the insulin sensitivity of patients and lead to abnormal energy metabolism by changing the host intestinal mucosal barrier,affecting the synthesis of short-chain fatty acid,abnormal bile acid metabolism and other mechanisms,which eventually lead to diabetes.The treatment of diabetes based on gut microbiota is also a hot research topic in the endocrine field.The use of probiotics,fecal flora transplantation and bariatric surgery can regulate gut microbiota,play a therapeutic effect on diabetes,and bring new hope for diabetes patients.