Luo Yu, Li Maojun, Luo Dan, Tang Binzhi
Department of Pediatrics, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Department of Pediatrics, School of Medicine and Life Science of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Adv Nutr. 2025 Feb;16(2):100362. doi: 10.1016/j.advnut.2024.100362. Epub 2024 Dec 28.
Increasing prevalence of childhood obesity has emerged as a critical global public health concern. Recent studies have challenged the previous belief that obesity was solely a result of excessive caloric intake. Alterations in early-life gut microbiota can contribute to childhood obesity through their influence on nutrient absorption and metabolism, initiation of inflammatory responses, and regulation of gut-brain communication. The gut microbiota is increasingly acknowledged to play a crucial role in human health, as certain beneficial bacteria have been scientifically proven to possess the capacity to reduce body fat content and enhance intestinal barrier function and their metabolic products to exhibit anti-inflammatory effect. Examples of such microbes include bifidobacteria, Akkermansia muciniphila, and Lactobacillus reuteri. In contrast, an increase in Enterobacteriaceae and propionate-producing bacteria (Prevotellaceae and Veillonellaceae) has been implicated in the induction of low-grade systemic inflammation and disturbances in lipid metabolism, which can predispose individuals to obesity. Studies have demonstrated that modulating the gut microbiota through diet, lifestyle changes, prebiotics, probiotics, or fecal microbiota transplantation may contribute to gut homeostasis and the management of obesity and its associated comorbidities. This review aimed to elucidate the impact of alterations in gut microbiota composition during early life on childhood obesity and explores the mechanisms by which gut microbiota contributes to the pathogenesis of obesity and specifically focused on recent advances in using short-chain fatty acids for regulating gut microbiota and ameliorating obesity. Additionally, it aimed to discuss the therapeutic strategies for childhood obesity from the perspective of gut microbiota, aiming to provide a theoretical foundation for interventions targeting pediatric obesity based on gut microbiota.
儿童肥胖患病率的上升已成为全球关键的公共卫生问题。最近的研究对先前认为肥胖仅仅是热量摄入过多所致的观点提出了挑战。早期肠道微生物群的改变可通过影响营养吸收和代谢、引发炎症反应以及调节肠脑通讯来导致儿童肥胖。肠道微生物群在人类健康中所起的关键作用日益得到认可,因为某些有益细菌已被科学证明具有降低体脂含量、增强肠道屏障功能的能力,且其代谢产物具有抗炎作用。这类微生物的例子包括双歧杆菌、嗜黏蛋白阿克曼氏菌和罗伊氏乳杆菌。相比之下,肠杆菌科以及产丙酸菌(普雷沃氏菌科和韦荣氏菌科)数量的增加与低度全身炎症的诱导及脂质代谢紊乱有关,这可能使个体易患肥胖症。研究表明,通过饮食、生活方式改变、益生元、益生菌或粪便微生物群移植来调节肠道微生物群,可能有助于维持肠道稳态以及管理肥胖症及其相关合并症。本综述旨在阐明生命早期肠道微生物群组成的改变对儿童肥胖的影响,并探讨肠道微生物群导致肥胖发病机制的方式,特别关注利用短链脂肪酸调节肠道微生物群和改善肥胖症方面的最新进展。此外,它旨在从肠道微生物群的角度讨论儿童肥胖的治疗策略,旨在为基于肠道微生物群的儿科肥胖干预提供理论基础。