Sagmeister Alexandra, Matter Christian M, Stähli Barbara E, Scharl Michael
Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
Department of Cardiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
Int J Mol Sci. 2024 Dec 17;25(24):13529. doi: 10.3390/ijms252413529.
Recent reports demonstrate an association between distinct bacteria or bacteria-derived metabolites originating from the gut microbiome and the onset or progression of cardiovascular disease (CVD). This raises the opportunity to modulate the gut microbiome to prevent or treat CVD. To investigate whether intestinal microbiome modulation can prevent or treat CVD, this systematic literature review includes all randomized clinical trials on microbiome modulation and its effects on CVD risk published between August 2018 and August 2023. Within this review, we report the modulation of the gut microbiome by a variety of interventions and their effects on CVD, focusing on cardiovascular risk factors and risk markers of CVD. Beneficial effects were observed upon lifestyle intervention and probiotics use. The most promising diets for reducing risk factors of CVD were the Mediterranean diet, high-fiber diets, polyphenol-rich diets, and diets containing polyunsaturated fatty acids. Among drug interventions, only empagliflozin showed beneficial effects on CVD risk factors. Many dietary interventions were less conclusive because of the heterogeneity of study populations, small sample sizes, and short intervention windows or follow-up. Diet, lifestyle, probiotics, or drug interventions can modulate the gut microbiome and decrease risk markers or risk factors related to CVD. Yet, their effects on clinical endpoints remain to be determined.
近期报告表明，源自肠道微生物群的不同细菌或细菌衍生代谢物与心血管疾病（CVD）的发生或进展之间存在关联。这为调节肠道微生物群以预防或治疗CVD提供了契机。为了研究肠道微生物群调节是否可以预防或治疗CVD，本系统文献综述纳入了2018年8月至2023年8月期间发表的所有关于微生物群调节及其对CVD风险影响的随机临床试验。在本综述中，我们报告了通过各种干预措施对肠道微生物群的调节及其对CVD的影响，重点关注心血管危险因素和CVD的风险标志物。在生活方式干预和使用益生菌后观察到了有益效果。对降低CVD危险因素最有前景的饮食是地中海饮食、高纤维饮食、富含多酚的饮食以及含有多不饱和脂肪酸的饮食。在药物干预中，只有恩格列净对CVD危险因素显示出有益效果。由于研究人群的异质性、样本量小以及干预窗口或随访时间短，许多饮食干预的结论性较差。饮食、生活方式、益生菌或药物干预可以调节肠道微生物群，并降低与CVD相关的风险标志物或危险因素。然而，它们对临床终点的影响仍有待确定。
