The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
Can J Diabetes. 2019 Apr;43(3):224-231. doi: 10.1016/j.jcjd.2019.01.007. Epub 2019 Jan 31.
The gut microbiota is an important regulator of host metabolism. Metagenome analyses have demonstrated that the gut microbiota differs between patients with type 2 diabetes and healthy subjects, and several studies have shown that impaired glucose metabolism is associated with decreased levels of butyrate-producing bacteria. Gut microbiota-produced metabolites, such as short-chain fatty acids, amino acid derivatives and secondary bile acids, participate in metabolic and immunologic processes and, hence, pose putative links between the gut microbiota and glucose homeostasis. Strategies to prevent and treat type 2 diabetes through manipulation of the gut microbiota are being developed. These include replacement of the gut microbiota by fecal transplantation, consumption of fibres to promote the function and growth of beneficial bacteria and treatment with probiotic bacterial strains. Furthermore, it has been shown that many drugs, including drugs used for treatment of diabetes, have major impacts on gut microbiota and, thereby, potentially on glucose metabolism. In particular, the commonly used drug metformin has been shown to influence the functional capacity of the gut microbiota, and recent evidence indicates that this may contribute to the antidiabetes effect of metformin.
肠道微生物群是宿主代谢的重要调节剂。宏基因组分析表明，2 型糖尿病患者和健康受试者的肠道微生物群存在差异，多项研究表明，葡萄糖代谢受损与产丁酸菌水平降低有关。肠道微生物群产生的代谢物，如短链脂肪酸、氨基酸衍生物和次级胆汁酸，参与代谢和免疫过程，因此肠道微生物群与葡萄糖稳态之间存在潜在联系。目前正在开发通过操纵肠道微生物群来预防和治疗 2 型糖尿病的策略。这些策略包括粪便移植来替代肠道微生物群，食用纤维来促进有益细菌的功能和生长，以及使用益生菌菌株进行治疗。此外，已经表明许多药物，包括用于治疗糖尿病的药物，对肠道微生物群有重大影响，从而可能对葡萄糖代谢有影响。特别是，常用药物二甲双胍已被证明会影响肠道微生物群的功能能力，最近的证据表明，这可能有助于二甲双胍的抗糖尿病作用。
