Medicine and Health Sciences Post-Graduate Program, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Obes Rev. 2017 Aug;18(8):832-851. doi: 10.1111/obr.12541. Epub 2017 May 19.
Imbalances in the gut microbiota, the bacteria that inhabit the intestines, are central to the pathogenesis of obesity. This systematic review assesses the association between the gut microbiota and weight loss in overweight/obese adults and its potential manipulation as a target for treating obesity. This review identified 43 studies using the keywords 'overweight' or 'obesity' and 'microbiota' and related terms; among these studies, 17 used dietary interventions, 11 used bariatric surgery and 15 used microbiota manipulation. The studies differed in their methodologies as well as their intervention lengths. Restrictive diets decreased the microbiota abundance, correlated with nutrient deficiency rather than weight loss and generally reduced the butyrate producers Firmicutes, Lactobacillus sp. and Bifidobacterium sp. The impact of surgical intervention depended on the given technique and showed a similar effect on butyrate producers, in addition to increasing the presence of the Proteobacteria phylum, which is related to changes in the intestinal absorptive surface, pH and digestion time. Probiotics differed in strain and duration with diverse effects on the microbiota, and they tended to reduce body fat. Prebiotics had a bifidogenic effect and increased butyrate producers, likely due to cross-feeding interactions, contributing to the gut barrier and improving metabolic outcomes. All of the interventions under consideration had impacts on the gut microbiota, although they did not always correlate with weight loss. These results show that restrictive diets and bariatric surgery reduce microbial abundance and promote changes in microbial composition that could have long-term detrimental effects on the colon. In contrast, prebiotics might restore a healthy microbiome and reduce body fat.
肠道微生物群的失衡，即栖息在肠道中的细菌，是肥胖发病机制的核心。本系统评价评估了超重/肥胖成年人的肠道微生物群与体重减轻之间的关联及其作为肥胖治疗靶点的潜在操纵。本综述确定了 43 项使用关键字“超重”或“肥胖”和“微生物组”及其相关术语的研究；其中 17 项研究使用饮食干预，11 项研究使用减肥手术，15 项研究使用微生物组操纵。这些研究在方法学以及干预时间长度上存在差异。限制饮食会减少微生物群的丰度，这与营养缺乏而不是体重减轻相关，并且通常会减少丁酸产生菌厚壁菌门、乳杆菌属和双歧杆菌属。手术干预的影响取决于所采用的技术，除了增加与肠道吸收表面、pH 值和消化时间变化相关的变形菌门的存在外，对丁酸产生菌也有类似的影响。益生菌在菌株和持续时间上存在差异，对微生物群有不同的影响，它们往往会减少体脂肪。益生元具有双歧杆菌作用，增加丁酸产生菌，可能是由于交叉喂养相互作用，有助于肠道屏障并改善代谢结果。所有考虑的干预措施都对肠道微生物群有影响，尽管它们并不总是与体重减轻相关。这些结果表明，限制饮食和减肥手术会减少微生物丰度，并促进微生物组成的变化，这可能对结肠产生长期的不利影响。相比之下，益生元可能会恢复健康的微生物组并减少体脂肪。
