Festi Davide, Schiumerini Ramona, Eusebi Leonardo Henry, Marasco Giovanni, Taddia Martina, Colecchia Antonio
Davide Festi, Ramona Schiumerini, Leonardo Henry Eusebi, Giovanni Marasco, Martina Taddia, Antonio Colecchia, Department of Digestive Diseases and Internal Medicine, University of Bologna, S Orsola Hospital, 40138 Bologna, Italy.
World J Gastroenterol. 2014 Nov 21;20(43):16079-94. doi: 10.3748/wjg.v20.i43.16079.
Gut microbiota exerts a significant role in the pathogenesis of the metabolic syndrome, as confirmed by studies conducted both on humans and animal models. Gut microbial composition and functions are strongly influenced by diet. This complex intestinal "superorganism" seems to affect host metabolic balance modulating energy absorption, gut motility, appetite, glucose and lipid metabolism, as well as hepatic fatty storage. An impairment of the fine balance between gut microbes and host's immune system could culminate in the intestinal translocation of bacterial fragments and the development of "metabolic endotoxemia", leading to systemic inflammation and insulin resistance. Diet induced weight-loss and bariatric surgery promote significant changes of gut microbial composition, that seem to affect the success, or the inefficacy, of treatment strategies. Manipulation of gut microbiota through the administration of prebiotics or probiotics could reduce intestinal low grade inflammation and improve gut barrier integrity, thus, ameliorating metabolic balance and promoting weight loss. However, further evidence is needed to better understand their clinical impact and therapeutic use.
肠道微生物群在代谢综合征的发病机制中发挥着重要作用，这已在人体和动物模型的研究中得到证实。肠道微生物组成和功能受饮食的强烈影响。这个复杂的肠道“超级生物体”似乎通过调节能量吸收、肠道蠕动、食欲、葡萄糖和脂质代谢以及肝脏脂肪储存来影响宿主代谢平衡。肠道微生物与宿主免疫系统之间的微妙平衡受到损害可能会导致细菌碎片的肠道易位和“代谢性内毒素血症”的发展，从而导致全身炎症和胰岛素抵抗。饮食诱导的体重减轻和减肥手术会促使肠道微生物组成发生显著变化，这似乎会影响治疗策略的成功与否。通过施用益生元或益生菌来操控肠道微生物群可以减轻肠道低度炎症并改善肠道屏障完整性，从而改善代谢平衡并促进体重减轻。然而，需要更多证据来更好地了解它们的临床影响和治疗用途。
