Department of Nutrition, School of Health, Golestan University of Medical Sciences, Gorgan, Iran.
Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.
Curr Diabetes Rev. 2024;20(10):e240124226068. doi: 10.2174/0115733998280396231212114345.
Diabetes is one of the chronic and very complex diseases that can lead to microvascular complications. Recent evidence demonstrates that dysbiosis of the microbiota composition might result in low-grade, local, and systemic inflammation, which contributes directly to the development of diabetes mellitus and its microvascular consequences.
The aim of this systematic review was to investigate the association between diabetes microvascular complications, including retinopathy, neuropathy, nephropathy, and gut microbiota composition.
A systematic search was carried out in PubMed, Scopus, and ISI Web of Science from database inception to March 2023. Screening, data extraction, and quality assessment were performed by two independent authors. The Newcastle-Ottawa Quality Assessment Scale was used for quality assessment.
About 19 articles were selected from 590 retrieved articles. Among the included studies, nephropathy has been studied more than other complications of diabetes, showing that the composition of the healthy microbiota is changed, and large quantities of uremic solutes that cause kidney injury are produced by gut microbes. Phyla, including Fusobacteria and Proteobacteria, accounted for the majority of the variation in gut microbiota between Type 2 diabetic patients with and without neuropathy. In cases with retinopathy, an increase in pathogenic and proinflammatory bacteria was observed.
Our results revealed that increases in Bacteroidetes, Proteobacteria and Fusobacteria may be associated with the pathogenesis of diabetic nephropathy, neuropathy, and retinopathy. In view of the detrimental role of intestinal dysbiosis in the development of diabetes-related complications, gut microbiota assessment may be used as a biomarker in the future and interventions that modulate the composition of microbiota in individuals with diabetes can be used to prevent and control these complications.
糖尿病是一种慢性且非常复杂的疾病，可导致微血管并发症。最近的证据表明，微生物群落组成的失调可能导致低度、局部和全身炎症，这直接导致糖尿病及其微血管后果的发展。
本系统评价旨在研究糖尿病微血管并发症（包括视网膜病变、神经病变、肾病和肠道微生物群落组成）之间的关联。
从数据库建立到 2023 年 3 月，在 PubMed、Scopus 和 ISI Web of Science 中进行了系统搜索。两名独立作者进行了筛选、数据提取和质量评估。使用纽卡斯尔-渥太华质量评估量表进行质量评估。
从 590 篇检索文章中选择了约 19 篇文章。在所纳入的研究中，肾病的研究多于其他糖尿病并发症，表明健康微生物群落的组成发生了变化，肠道微生物产生了大量导致肾脏损伤的尿毒症溶质。厚壁菌门和变形菌门等菌门在 2 型糖尿病患者中占优势，这些患者有无神经病变的肠道微生物群落存在大量差异。在视网膜病变的情况下，观察到致病性和促炎细菌增加。
我们的结果表明，拟杆菌门、变形菌门和梭杆菌门的增加可能与糖尿病肾病、神经病变和视网膜病变的发病机制有关。鉴于肠道菌群失调在糖尿病相关并发症发展中的有害作用，肠道微生物群评估将来可能被用作生物标志物，调节糖尿病个体中微生物群落组成的干预措施可用于预防和控制这些并发症。
