Università Cattolica del Sacro Cuore, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Division of Diabetes & Nutritional Sciences, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, United Kingdom.
Peptides. 2024 Aug;178:171216. doi: 10.1016/j.peptides.2024.171216. Epub 2024 Apr 16.
Over the past 40 years, the prevalence of obesity has risen dramatically, reaching epidemic proportions. By 2030 the number of people affected by obesity will reach 1.12 billion worldwide. Gastrointestinal hormones, namely incretins, play a vital role in the pathogenesis of obesity and its comorbidities. GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1), which are secreted from the intestine after nutrient intake and stimulate insulin secretion from pancreatic β cells, influence lipid metabolism, gastric empting, appetite and body weight. The gut microbiota plays an important role in various metabolic conditions, including obesity and type 2 diabetes and influences host metabolism through the interaction with enteroendocrine cells that modulate incretins secretion. Gut microbiota metabolites, such as short-chain fatty acids (SCFAs) and indole, directly stimulate the release of incretins from colonic enteroendocrine cells influencing host satiety and food intake. Moreover, bariatric surgery and incretin-based therapies are associated with increase gut bacterial richness and diversity. Understanding the role of incretins, gut microbiota, and their metabolites in regulating metabolic processes is crucial to develop effective strategies for the management of obesity and its associated comorbidities.
在过去的 40 年中，肥胖的患病率急剧上升，达到了流行的程度。到 2030 年，全世界肥胖患者的人数将达到 11.2 亿。胃肠道激素，即肠促胰岛素，在肥胖及其合并症的发病机制中起着至关重要的作用。GIP（葡萄糖依赖性胰岛素促分泌肽）和 GLP-1（胰高血糖素样肽-1）在摄入营养物质后从肠道分泌，并刺激胰腺β细胞分泌胰岛素，影响脂代谢、胃排空、食欲和体重。肠道微生物群在各种代谢状况中起着重要作用，包括肥胖和 2 型糖尿病，并通过与调节肠促胰岛素分泌的肠内分泌细胞相互作用来影响宿主代谢。肠道微生物群的代谢产物，如短链脂肪酸（SCFAs）和吲哚，直接刺激结肠肠内分泌细胞释放肠促胰岛素，影响宿主饱腹感和食物摄入。此外，减重手术和肠促胰岛素治疗与增加肠道细菌丰富度和多样性有关。了解肠促胰岛素、肠道微生物群及其代谢产物在调节代谢过程中的作用对于开发肥胖及其相关合并症的有效管理策略至关重要。
