代谢性疾病与嗅觉改变及其机制进展

Progress of olfactory changes in metabolic diseases and the mechanisms

代谢性疾病发病机制复杂,其患病率逐年上升且发病趋向年轻化,已成为全球重要的公共卫生问题。嗅觉是一种重要的感觉功能,在个体的营养和生活质量方面发挥着重要作用。肥胖与嗅觉功能可以相互影响,嗅觉功能受到营养状况的影响,同时在食物摄入、能量消耗和脂质代谢的调节过程中也发挥重要作用,而2型糖尿病、阻塞性睡眠呼吸暂停综合征等代谢性疾病患者也存在嗅觉功能障碍。代谢性疾病出现嗅觉改变的机制包括高血糖、胰岛素抵抗等代谢状态的改变,这些改变可引起肽类激素、脂肪细胞因子和神经递质的调节异常,这些中介分子可能在代谢性疾病和嗅觉功能障碍之间发挥作用;代谢性疾病所产生的血管与神经病变也会引起嗅觉神经的直接损伤或神经传导异常;代谢性疾病导致的肠道菌群紊乱也是引起嗅觉功能障碍的潜在机制。同时,认知功能障碍是代谢性疾病的重要并发症,嗅觉功能障碍是代谢性疾病出现认知障碍的前驱临床表现,有助于疾病的早期识别和评估。该文对代谢性疾病与嗅觉变化之间的关系及其潜在机制的研究现状作一综述。

Metabolic disorders,characterized by a complex pathogenesis,are experiencing a rising prevalence globally and a trend toward younger populations,making them a significant public health concern.Olfaction,a crucial sensory function,plays a pivotal role in an individual′s nutrition and quality of life.There is a bidirectional relationship between obesity and olfactory function.Olfaction is influenced by nutritional status;simultaneously,it plays a vital role in the regulation of food intake,energy expenditure,and lipid metabolism.Moreover,individuals with metabolic disorders such as type 2 diabetes and obstructive sleep apnea syndrome exhibit olfactory dysfunction.Mechanisms underlying olfactory changes in metabolic disorders involve alterations in metabolic states such as hyperglycemia and insulin resistance.These changes can lead to dysregulation of peptide hormones,adipocyte factors,and neurotransmitters,which may potentially act as mediators between metabolic disorders and olfactory dysfunction.Vascular and neural alterations resulting from metabolic disorders can directly damage olfactory nerves or induce abnormal neural transmission.Furthermore,dysbiosis in the gut microbiota induced by metabolic disorders is a potential mechanism for olfactory dysfunction.Cognitive dysfunction is a significant complication of metabolic disorders.Olfactory dysfunction can serve as an early clinical manifestation of cognitive impairment and contributes to early identification and assessment of diseases.This article reviews recent researches on the relationship between metabolic diseases and olfactory changes and the potential mechanisms.