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粪便微生物群移植在肥胖代谢中的作用:荟萃分析和系统评价。

Fecal microbiota transplantation in obesity metabolism: A meta analysis and systematic review.

机构信息

Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Chaoyang, Beijing, China.

China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Chaoyang, Beijing, China.

出版信息

Diabetes Res Clin Pract. 2023 Aug;202:110803. doi: 10.1016/j.diabres.2023.110803. Epub 2023 Jun 24.

Abstract

OBJECTIVE

The effect of fecal microbiota transplantation (FMT) on microbiota engraftment in patients with metabolic syndrome remains unclear. This systematic review employed a meta-analysis of RCTs for assessment on the role of FMT in treating obesity and metabolic syndrome, and its impact on clinically relevant parameters.

METHOD

Major databases and grey literatures were searched identifying RCTs comparing FMT of lean donors with placebo in obese/metabolic syndrome patients. Studies using any form of placebo were included. Variations in the parameters before and after treatment were calculated followed by meta-analyses.

RESULT

Ten studies met the inclusion criteria and a total of 334 patients were included for further analysis. Clinically significant parameters associated with obesity and metabolic syndrome were explored and FMT was identified significantly and negatively associated with most indices of abdominal adiposity including caloric intake, fasting glucose, HOMA-IR, systolic blood pressure, diastolic blood pressure, total cholesterol, HDL, LDL, triglycerides and CRP, Obesity parameters including fasting glucose and acetic acid were increased following FMT.

CONCLUSION

FMT is more advantageous for obese patients with elevated blood pressure, disordered glucose and insulin metabolism, and elevated blood lipids. The study of metabolic factors in obese patients will be our starting point in the future.

摘要

目的

粪便微生物群移植(FMT)对代谢综合征患者微生物群定植的影响尚不清楚。本系统评价采用随机对照试验的荟萃分析评估 FMT 在治疗肥胖和代谢综合征中的作用及其对临床相关参数的影响。

方法

检索主要数据库和灰色文献,以确定将瘦供体的 FMT 与肥胖/代谢综合征患者的安慰剂进行比较的 RCT。纳入使用任何形式安慰剂的研究。计算治疗前后参数的变化,然后进行荟萃分析。

结果

符合纳入标准的研究有 10 项,共纳入 334 名患者进行进一步分析。探讨了与肥胖和代谢综合征相关的临床显著参数,发现 FMT 与腹部肥胖的大多数指标显著负相关,包括热量摄入、空腹血糖、HOMA-IR、收缩压、舒张压、总胆固醇、HDL、LDL、甘油三酯和 CRP,肥胖参数包括空腹血糖和乙酸在 FMT 后增加。

结论

FMT 更有利于血压升高、葡萄糖和胰岛素代谢紊乱、血脂升高的肥胖患者。未来我们将以肥胖患者的代谢因素为研究起点。

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