Palmnäs-Bédard Marie S A, Costabile Giuseppina, Vetrani Claudia, Åberg Sebastian, Hjalmarsson Yommine, Dicksved Johan, Riccardi Gabriele, Landberg Rikard
Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden.
Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Am J Clin Nutr. 2022 Oct 6;116(4):862-874. doi: 10.1093/ajcn/nqac217.
The gut microbiota plays a fundamental role in human nutrition and metabolism and may have direct implications for type 2 diabetes and associated preconditions. An improved understanding of relations between human gut microbiota and glucose metabolism could lead to novel opportunities for type 2 diabetes prevention, but human observational studies reporting on such findings have not been extensively reviewed. Here, we review the literature on associations between gut microbiota and markers and stages of glucose dysregulation and insulin resistance in healthy adults and in adults with metabolic disease and risk factors. We present the current evidence for identified key bacteria and their potential roles in glucose metabolism independent of overweight, obesity, and metabolic drugs. We provide support for SCFAs mediating such effects and discuss the role of diet, as well as metabolites derived from diet and gut microbiota interactions. From 5983 initially identified PubMed records, 45 original studies were eligible and reviewed. α Diversity and 45 bacterial taxa were associated with selected outcomes. Six taxa were most frequently associated with glucose metabolism: Akkermansia muciniphila, Bifidobacterium longum, Clostridium leptum group, Faecalibacterium prausnitzii, and Faecalibacterium (inversely associated) and Dorea (directly associated). For Dorea and A. muciniphila, associations were independent of metabolic drugs and body measures. For A. muciniphila and F. prausnitzii, limited evidence supported SCFA mediation of potential effects on glucose metabolism. We conclude that observational studies applying metagenomics sequencing to identify species-level relations are warranted, as are studies accounting for confounding factors and investigating SCFA and postprandial glucose metabolism. Such advances in the field will, together with mechanistic and prospective studies and investigations into diet-gut microbiota interactions, have the potential to bring critical insight into roles of gut microbiota and microbial metabolites in human glucose metabolism and to contribute toward the development of novel prevention strategies for type 2 diabetes, including precision nutrition.
肠道微生物群在人类营养和代谢中起着重要作用,可能对2型糖尿病及相关前期病症有直接影响。更好地理解人类肠道微生物群与葡萄糖代谢之间的关系可能会为2型糖尿病的预防带来新机遇,但关于此类发现的人类观察性研究尚未得到广泛综述。在此,我们综述了关于肠道微生物群与健康成年人以及患有代谢疾病和风险因素的成年人中葡萄糖调节异常和胰岛素抵抗的标志物及阶段之间关联的文献。我们展示了已确定的关键细菌及其在独立于超重、肥胖和代谢药物的葡萄糖代谢中潜在作用的现有证据。我们为短链脂肪酸介导此类效应提供了支持,并讨论了饮食的作用以及饮食与肠道微生物群相互作用产生的代谢产物。从最初在PubMed中检索到的5983条记录中,筛选出45项原始研究进行综述。α多样性和45个细菌分类群与选定结果相关。六个分类群与葡萄糖代谢的关联最为频繁:嗜黏蛋白阿克曼氏菌、长双歧杆菌、纤细梭菌属菌群、普拉梭菌和粪杆菌属(呈负相关)以及多雷菌属(呈正相关)。对于多雷菌属和嗜黏蛋白阿克曼氏菌,其关联独立于代谢药物和身体指标。对于嗜黏蛋白阿克曼氏菌和普拉梭菌,有限的证据支持短链脂肪酸介导对葡萄糖代谢的潜在影响。我们得出结论,开展应用宏基因组测序来确定物种水平关系的观察性研究很有必要,考虑混杂因素以及研究短链脂肪酸和餐后葡萄糖代谢的研究也很有必要。该领域的这些进展,连同机制性研究、前瞻性研究以及对饮食与肠道微生物群相互作用的研究,有可能为肠道微生物群和微生物代谢产物在人类葡萄糖代谢中的作用带来关键见解,并有助于开发包括精准营养在内的2型糖尿病新型预防策略。