Homayouni-Rad Aziz, Soroush Ahmad-Reza, Khalili Leila, Norouzi-Panahi Leila, Kasaie Zahra, Ejtahed Hanieh-Sadat
1 Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, I. R. Iran.
2 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, I. R. Iran.
Int J Vitam Nutr Res. 2016 Jun;86(3-4):215-227. doi: 10.1024/0300-9831/a000273. Epub 2017 Apr 24.
Diabetes mellitus, a multifactorial disorder, is related to the intestinal microbiota via numerous molecular mechanisms. The vast increase in the prevalence of diabetes and its associated complications requires a natural and safe solution. There is a growing evidence of gut microbiota effi ciency in improving insulin resistance, impaired insulin secretion, and metabolic complications in diabetic patients. Probiotics are defi ned as live microorganisms that, when ingested in adequate amounts, exert health benefi ts to the host. Probiotics can increase insulin sensitivity and reduce autoimmune responses by modulating intestinal microbiota and decreasing the infl ammatory reactions and oxidative stress. Recent evidences show that the intestinal microbiota infl uences the host through modulating intestinal permeability and mucosal immune response, manipulating eating behaviors by appetite-regulating hormones, including agouti related protein (AgRP), glucagon like peptide-1 (GLP-1) and neuropeptide Y, and controlling gut endocannabinoid (eCB) system which is now believed to be associated with infl ammation and diabetes. Moreover, intestinal microbiota control the host metabolism by affecting energy extraction from food and by biochemically converting molecules derived from the host or from gut microbes themselves. Experimental studies and clinical trials support the hypothesis that the modulation of the intestinal microbiota by probiotics, especially Lactobacillus and Bifidobacterium strains may be effective in prevention and management of diabetes. This review will highlight the current evidences in probiotic effectiveness and future prospects for exploring probiotic therapy in prevention and control of diabetes.
糖尿病是一种多因素疾病，通过多种分子机制与肠道微生物群相关。糖尿病及其相关并发症患病率的大幅上升需要一种天然且安全的解决方案。越来越多的证据表明，肠道微生物群在改善糖尿病患者的胰岛素抵抗、胰岛素分泌受损和代谢并发症方面具有功效。益生菌被定义为摄入足够量时能对宿主产生健康益处的活微生物。益生菌可通过调节肠道微生物群、减少炎症反应和氧化应激来提高胰岛素敏感性并降低自身免疫反应。最近的证据表明，肠道微生物群通过调节肠道通透性和黏膜免疫反应、通过食欲调节激素（包括刺鼠相关蛋白（AgRP）、胰高血糖素样肽-1（GLP-1）和神经肽Y）操纵饮食行为以及控制肠道内源性大麻素（eCB）系统来影响宿主，现在认为该系统与炎症和糖尿病有关。此外，肠道微生物群通过影响从食物中提取能量以及通过对源自宿主或肠道微生物自身的分子进行生化转化来控制宿主代谢。实验研究和临床试验支持这样的假设，即益生菌，尤其是乳酸杆菌和双歧杆菌菌株对肠道微生物群的调节可能对糖尿病的预防和管理有效。本综述将重点介绍益生菌有效性的当前证据以及探索益生菌疗法在糖尿病预防和控制方面的未来前景。
