University of Bonn, Institute of Nutrition and Food Sciences, Nutrition and Microbiota, Bonn, Germany.
University of Bonn, Life & Medical Sciences (LIMES) Institute, Department for Genomics and Immunoregulation, Bonn, Germany.
Exp Clin Endocrinol Diabetes. 2024 May;132(5):267-278. doi: 10.1055/a-2273-5602. Epub 2024 Feb 21.
Diabetes mellitus is one of the most prevalent chronic diseases. Previous studies have shown differences in glucose metabolism between males and females. Moreover, difficulties in medication adherence have been reported in females with type 2 diabetes. These observations are believed to be caused by fluctuations in sex hormone concentrations during the menstrual cycle. Furthermore, gut microbiota is linked to female host metabolism and sex hormone production. Understanding the interactions between fluctuating hormone concentrations during the menstrual cycle, gut microbiota, and glucose metabolism in humans is significant because of the increasing prevalence of diabetes and the consequent need to expand preventive efforts. A literature search was performed to determine and summarize the existing evidence, deduce future research needs to maintain female health, and investigate the relationship between the physiological menstrual cycle and glucose metabolism. Studies from 1967 to 2020 have already examined the relationship between variations during the menstrual cycle and glucose metabolism in healthy female subjects using an oral-glucose tolerance test or intravenous glucose tolerance test. However, the overall number of studies is rather small and the results are contradictory, as some studies detected differences in glucose concentrations depending on the different cycle phases, whereas others did not. Some studies reported lower glucose levels in the follicular phase than in the luteal phase, whereas another study detected the opposite. Data on gut microbiota in relation to the menstrual cycle are limited. Conflicting results exist when examining the effect of hormonal contraceptives on the gut microbiota and changes in the course of the menstrual cycle. The results indicate that the menstrual cycle, especially fluctuating sex hormones, might impact the gut microbiota composition.The menstrual cycle may affect the gut microbiota composition and glucose metabolism. These results indicate that glucose tolerance may be the greatest in the follicular phase; however, further well-conducted studies are needed to support this assumption.
糖尿病是最常见的慢性疾病之一。先前的研究表明,男性和女性的葡萄糖代谢存在差异。此外,有研究报道 2 型糖尿病女性在药物治疗依从性方面存在困难。这些观察结果被认为是由月经周期中性激素浓度的波动引起的。此外,肠道微生物群与女性宿主代谢和性激素的产生有关。了解月经周期中激素浓度的波动、肠道微生物群和葡萄糖代谢之间的相互作用非常重要,因为糖尿病的患病率不断增加,需要扩大预防措施。进行了文献检索,以确定和总结现有证据,推断维持女性健康的未来研究需求,并研究生理月经周期与葡萄糖代谢之间的关系。1967 年至 2020 年的研究已经使用口服葡萄糖耐量试验或静脉葡萄糖耐量试验研究了健康女性受试者月经周期变化与葡萄糖代谢之间的关系。然而,总的研究数量相当少,结果也存在矛盾,因为一些研究发现葡萄糖浓度随不同的周期阶段而变化,而另一些研究则没有。一些研究报告说卵泡期的葡萄糖水平低于黄体期,而另一项研究则检测到相反的结果。关于肠道微生物群与月经周期的关系的数据有限。在检查激素避孕药对肠道微生物群的影响以及月经周期的变化时,存在相互矛盾的结果。结果表明,月经周期,尤其是波动的性激素,可能会影响肠道微生物群的组成。月经周期可能会影响肠道微生物群的组成和葡萄糖代谢。这些结果表明,在卵泡期,葡萄糖耐量可能最大;然而,需要进一步进行精心设计的研究来支持这一假设。