Koller Ana Maria, Săsăran Maria Oana, Mărginean Cristina Oana
Doctoral School, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Street No 38, 540136 Targu Mures, Romania.
Department of Pediatrics 3, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Street No 38, 540136 Targu Mures, Romania.
Nutrients. 2025 Apr 29;17(9):1499. doi: 10.3390/nu17091499.
Childhood obesity is a growing global concern linked to metabolic disorders such as nonalcoholic fatty liver disease (NAFLD). Small intestinal bacterial overgrowth (SIBO) may exacerbate these conditions by promoting systemic inflammation and metabolic dysfunction. This review evaluates the prevalence of SIBO in obese children, its association with inflammatory and metabolic markers, and the efficacy of diagnostic and therapeutic strategies. A systematic search of PubMed, Scopus, and Web of Science (2010-present) was conducted using Boolean operators: ('small intestinal bacterial overgrowth' OR 'SIBO') AND 'prevalence' AND ('low-grade inflammatory markers' OR 'metabolic status') AND 'gut microbiome' AND 'dysbiosis' AND 'obese children'. The data show that SIBO is frequently observed in obese pediatric populations and is associated with gut dysbiosis, impaired nutrient absorption, and reduced production of short-chain fatty acids. These changes contribute to increased intestinal permeability, endotoxemia, and chronic low-grade inflammation. Several microbial taxa have been proposed as biomarkers and therapeutic targets. Diagnostic inconsistencies persist, but treatments such as probiotics, prebiotics, dietary interventions, and selective antibiotics show potential, pending further validation. Early identification and treatment of SIBO with tailored strategies may help reduce metabolic complications and improve outcomes in children with obesity.
儿童肥胖是一个日益引起全球关注的问题，与诸如非酒精性脂肪性肝病（NAFLD）等代谢紊乱有关。小肠细菌过度生长（SIBO）可能通过促进全身炎症和代谢功能障碍而加剧这些情况。本综述评估了肥胖儿童中SIBO的患病率、其与炎症和代谢标志物的关联以及诊断和治疗策略的疗效。使用布尔运算符对PubMed、Scopus和Web of Science（2010年至今）进行了系统检索：（“小肠细菌过度生长”或“SIBO”）且“患病率”且（“低度炎症标志物”或“代谢状态”）且“肠道微生物群”且“生态失调”且“肥胖儿童”。数据表明，在肥胖的儿科人群中经常观察到SIBO，并且它与肠道生态失调、营养吸收受损以及短链脂肪酸产生减少有关。这些变化导致肠道通透性增加、内毒素血症和慢性低度炎症。几种微生物分类群已被提议作为生物标志物和治疗靶点。诊断上的不一致仍然存在，但诸如益生菌、益生元、饮食干预和选择性抗生素等治疗方法显示出潜力，有待进一步验证。早期识别并采用量身定制的策略治疗SIBO可能有助于减少肥胖儿童的代谢并发症并改善其预后。
