EA4466, Département de Biologie Expérimentale, Métabolique et Clinique, Faculté des Sciences Pharmaceutiques Paris Descartes, Clinical Chemistry, Cochin-Broca-Hotel Dieu, APHP, Paris, France.
Curr Opin Clin Nutr Metab Care. 2011 Jul;14(4):334-40. doi: 10.1097/MCO.0b013e328347924a.
The gut microbiota is a very complex ecosystem which interacts extensively with the host, influencing multiple metabolic and physiological functions. Several diseases have been shown to be associated with specific alterations in gut microbiota. It is more and more underscored as playing a major role in the development of insulin resistance and inflammation associated with excess weight gain.
Recent studies in obese patients have shown perturbations in gut microbiota with a weight gain-associated increase in the Firmicutes/Bacteroidetes ratio ameliorated by various attempts at inducing weight loss.
Intestinal microbiota may contribute to the development of inflammation and insulin resistance by two main mechanisms. First, gut microbiota might facilitate energy harvest from the gut leading via perturbation in energy homeostasis to fat deposition and increased adipokine production and plasma free fatty acid levels both contributing to insulin resistance and inflammation. Alternatively, it can initiate an inflammatory process either originating from the intestine or generated at the peripheral level via endotoxin leakage into the blood from the intestine, both leading secondarily to insulin resistance.
肠道微生物群是一个非常复杂的生态系统，与宿主广泛相互作用，影响多种代谢和生理功能。已有研究表明，多种疾病与肠道微生物群的特定改变有关。越来越多的证据表明，肠道微生物群在与体重增加相关的胰岛素抵抗和炎症的发展中起主要作用。
最近在肥胖患者中的研究表明，肠道微生物群发生了改变，与体重增加相关的厚壁菌门/拟杆菌门比值增加，通过各种减肥尝试得到改善。
肠道微生物群可能通过两种主要机制促进炎症和胰岛素抵抗的发展。首先，肠道微生物群可能有助于从肠道中获取能量，通过能量稳态的改变导致脂肪沉积和增加脂肪因子的产生和血浆游离脂肪酸水平，这两者都导致胰岛素抵抗和炎症。其次，它可以通过肠内或外周水平的内毒素从肠内漏出到血液中引发炎症过程，两者都导致胰岛素抵抗。
