School of Pharmacy and Graduate Institute, China Medical University, Taichung City, Taiwan.
Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam.
Front Endocrinol (Lausanne). 2020 Sep 23;11:573891. doi: 10.3389/fendo.2020.573891. eCollection 2020.
As growing evidence links gut microbiota with the therapeutic efficacy and side effects of anti-hyperglycemic drugs, this article aims to provide a systematic review of the reciprocal interactions between anti-hyperglycemic drugs and gut microbiota taxa, which underlie the effect of the gut microbiome on diabetic control via bug-host interactions. We followed the PRISMA requirements to perform a systematic review on human vs. animal gut microbiota data in PubMed, SCOPUS, and EMBASE databases, and used Cochrane, ROBIN-I, and SYRCLE tools to assess potential bias risks. The outcomes of assessment were trends on gut microbiota taxa, diversity, and associations with metabolic control (e.g., glucose, lipid) following anti-hyperglycemic treatment. Of 2,804 citations, 64 studies (17/humans; 47/mice) were included. In human studies, seven were randomized trials using metformin or acarbose in obese, pre-diabetes, and type 2 diabetes (T2D) patients. Treatment of pre-diabetes and newly diagnosed T2D patients with metformin or acarbose was associated with decreases in genus of , accompanied by increases in both and . Additionally, T2D patients receiving metformin showed increases in various taxa of the order and the species . Of seven studies with significant differences in beta-diversity, the incremental specific taxa were associated with the improvement of glucose and lipid profiles. In mice, the effects of metformin on were similar, but an inverse association with was reported. Animal studies on other anti-hyperglycemic drugs, however, showed substantial variations in results. The changes in specific taxa and β-diversity of gut microbiota were associated with metformin and acarbose in humans while pertinent information for other anti-hyperglycemic drugs could only be obtained in rodent studies. Further human studies on anti-hyperglycemic drugs other than metformin and acarbose are needed to explore gut microbiota's role in their therapeutic efficacies and side effects.
越来越多的证据表明肠道微生物群与抗高血糖药物的治疗效果和副作用有关，本文旨在系统综述抗高血糖药物与肠道微生物群分类群之间的相互作用，这些相互作用是通过宿主与微生物之间的相互作用，肠道微生物组对糖尿病控制产生影响的基础。我们按照 PRISMA 要求，在 PubMed、SCOPUS 和 EMBASE 数据库中对人类与动物肠道微生物群数据进行了系统综述，并使用 Cochrane、ROBIN-I 和 SYRCLE 工具评估了潜在的偏倚风险。评估的结果是，在接受抗高血糖治疗后，肠道微生物群分类群的趋势、多样性以及与代谢控制（如葡萄糖、脂质）的相关性。在 2804 条引用中，有 64 项研究（17 项/人类；47 项/小鼠）被纳入。在人类研究中，有 7 项是使用二甲双胍或阿卡波糖治疗肥胖、前驱糖尿病和 2 型糖尿病（T2D）患者的随机试验。二甲双胍或阿卡波糖治疗前驱糖尿病和新诊断的 T2D 患者与属的减少有关，同时和的增加有关。此外，接受二甲双胍治疗的 T2D 患者表现出各种属的增加，和属的增加。在 7 项具有显著差异的 β-多样性的研究中，递增的特定分类群与葡萄糖和脂质谱的改善有关。在小鼠中，二甲双胍对的影响相似，但报道了与呈负相关。然而，关于其他抗高血糖药物的动物研究结果差异很大。人类中，特定分类群和肠道微生物群 β-多样性的变化与二甲双胍和阿卡波糖有关，而其他抗高血糖药物的相关信息只能从啮齿动物研究中获得。需要进一步开展非二甲双胍和阿卡波糖的抗高血糖药物的人类研究，以探讨肠道微生物群在其治疗效果和副作用中的作用。
