Krauze Wiktoria, Busz Nikola, Pikuła Weronika, Maternowska Martyna, Prowans Piotr, Maciejewska-Markiewicz Dominika
Department of Human Nutrition and Metabolomics, Pomeranian Medical University, 71-460 Szczecin, Poland.
Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, 72-010 Szczecin, Poland.
Nutrients. 2025 May 22;17(11):1753. doi: 10.3390/nu17111753.
Type 2 diabetes mellitus (T2DM) represents a major global health burden, with prevalence rates escalating due to rapid urbanization, economic growth, and the obesity epidemic. Despite intensive research, the underlying molecular mechanisms remain incompletely understood, with emerging evidence suggesting multifactorial origins involving genetic, epigenetic, lifestyle, and environmental factors. This review synthesizes current epidemiological data on T2DM prevalence, risk factors, and demographic patterns from 1990 to 2017, and discusses projected trends through 2030. We examine the role of intestinal barrier dysfunction and gut microbiota dysbiosis in T2DM pathogenesis, highlighting key mechanistic insights. Furthermore, we analyze recent findings on the role of butyrate, a major short-chain fatty acid, in preserving gut integrity and its potential therapeutic effects on metabolic health. Global T2DM prevalence has risen markedly across all age groups, with particularly high rates in Western Europe and Pacific Island nations. Disruption of the intestinal barrier ("leaky gut") and gut microbiota alterations contribute significantly to systemic inflammation and insulin resistance, which are pivotal features in T2DM development. Butyrate plays a central role in maintaining epithelial barrier function, modulating immune responses, and regulating glucose metabolism. Preclinical studies have demonstrated that sodium butyrate supplementation improves gut integrity, reduces systemic endotoxemia, and ameliorates metabolic parameters. Emerging clinical evidence suggests benefits of sodium butyrate, particularly when combined with prebiotic fibers, in improving glycemic control and reducing inflammatory markers in T2DM patients. Gut barrier integrity and microbiota composition are critical factors in T2DM pathogenesis. Sodium butyrate shows promise as a complementary therapeutic agent in T2DM management, although further large-scale, long-term clinical trials are required to confirm its efficacy and safety. Targeting gut health may represent a novel strategy for the prevention and treatment of T2DM.
2型糖尿病(T2DM)是全球主要的健康负担,由于快速城市化、经济增长和肥胖流行,其患病率不断攀升。尽管进行了深入研究,但其潜在分子机制仍未完全明了,新证据表明其起源涉及遗传、表观遗传、生活方式和环境等多方面因素。本综述综合了1990年至2017年关于T2DM患病率、危险因素和人口统计学模式的当前流行病学数据,并讨论了到2030年的预测趋势。我们研究了肠道屏障功能障碍和肠道微生物群失调在T2DM发病机制中的作用,突出了关键的机制性见解。此外,我们分析了关于丁酸(一种主要的短链脂肪酸)在维持肠道完整性中的作用及其对代谢健康的潜在治疗效果的最新研究结果。全球T2DM患病率在所有年龄组中均显著上升,在西欧和太平洋岛国尤其高。肠道屏障破坏(“肠漏”)和肠道微生物群改变显著导致全身炎症和胰岛素抵抗,这是T2DM发展的关键特征。丁酸在维持上皮屏障功能、调节免疫反应和调节葡萄糖代谢中起核心作用。临床前研究表明,补充丁酸钠可改善肠道完整性、降低全身内毒素血症并改善代谢参数。新出现的临床证据表明,丁酸钠,特别是与益生元纤维联合使用时,对改善T2DM患者的血糖控制和降低炎症标志物有好处。肠道屏障完整性和微生物群组成是T2DM发病机制中的关键因素。丁酸钠有望成为T2DM管理中的一种辅助治疗药物,尽管需要进一步的大规模、长期临床试验来证实其疗效和安全性。针对肠道健康可能代表了一种预防和治疗T2DM的新策略。