实用医学杂志 ›› 2022, Vol. 38 ›› Issue (3): 261-265.doi: 10.3969/j.issn.1006⁃5725.2022.03.001

• 专家笔谈 •    下一篇

肠道菌群:未来2型糖尿病治疗的新靶点

梁磊 ,念馨   

  1. 昆明医科大学第一附属医院内分泌一科(昆明 650032)

  • 出版日期:2022-02-10 发布日期:2022-02-10
  • 通讯作者: 念馨 E⁃mail:nianxinkm@hotmail.com
  • 基金资助:
    国家自然科学基金地区科学基金资助项目(编号:81660153);云南省卫生和计划生育委员会医学学科带头人培养计划资助项目(编号:D⁃2017041)

Intestinal microbiota:a new target for treatment of type 2 diabetes in future

LIANG Lei,NIAN Xin.    

  1. Depart⁃ment of Endocrinology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China

  • Online:2022-02-10 Published:2022-02-10
  • Contact: NIAN Xin E⁃mail:nianxinkm@hotmail.com

摘要:

随着饮食、运动、传统降糖药和减肥手术过程中肠道微生物区系改变的发现,肠道菌群与2 型糖尿病(T2DM)的关联引起医学领域广泛的关注,肠道菌群也被证实与 T2DM 发生发展有着密切的关系。肠道菌群作用 T2DM 的治疗主要是通过调控肠道微生物区系,增加肠道产短链脂肪酸细菌的组成,通过影响胆汁酸代谢,降低肠道内毒素,增强肠道屏障功能,进而减轻全身炎症反应,改善 T2DM 的胰岛素抵抗。在此基础上,提出和证实了益生菌、益生元和粪菌移植等新型肠道菌群治疗方法在 T2DM 治疗中的作用。虽然肠道菌群被认为是未来 T2DM 治疗的新靶点,但目前这些新型的肠道菌群治疗方法应用于临床具有一定局限性,肠道菌群的复杂性、新型治疗方法循证医学和临床大数据的缺乏等问题都需要未来的进一步探索和研究。

关键词: 2型糖尿病, 肠道菌群, 机制, 临床应用

Abstract:

The discovery in intestinal microflora changes during treatment of type 2 diabetes mellitus(T2DM)by dietary therapy,exercise therapy,traditional hypoglycemic drugs and bariatric surgery has arousedthe interest of medical world in the association between intestinal flora and T2DM. Meanwhile,the intestinal florahas also been proved to be closely related to the occurrence and development of T2DM. T2DM is treated by improv⁃ing its insulin resistance,in mechanism,mainly through regulating intestinal microflora,increasing the composi⁃tion of intestinal short ⁃chain fatty acid ⁃producing bacteria,reducing intestinal endotoxin and enhancing intestinalbarrier function by affecting bile acid metabolism and then reducing systemic inflammatory response. On this basis,the role of probiotics,prebiotics and fecal bacteria transplantation in the treatment of T2DM has been proposed andconfirmed. Although intestinal flora is considered as a new therapeutic target for T2DM in the future,the applica⁃tion of these new therapeutic approaches to intestinal flora has certain limitations in clinical application. The com⁃plexity of intestinal flora,evidence⁃based medicine of new therapeutic approaches and lack of clinical big data allrequire further exploration and research in the future.

Key words:

type 2 diabetes, gut microbiota, mechanism, clinical applications