Borrego-Ruiz Alejandro, Borrego Juan J
Departamento de Psicología Social y de las Organizaciones, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain.
Departamento de Microbiología, Universidad de Málaga, 29071 Málaga, Spain.
Biomedicines. 2025 Sep 5;13(9):2173. doi: 10.3390/biomedicines13092173.
An estimated 2.6 billion individuals are currently living with overweight or obesity, and this number is projected to exceed 4 billion by 2035. Consequently, unless this increasing trajectory is effectively addressed, the trend is expected to continue in the coming years. The gut microbiome has emerged as a central regulator of host metabolism and energy homeostasis, making its detailed characterization crucial for the advancement of innovative therapeutic strategies and for elucidating mechanisms underlying metabolic health and disease. This review examines human obesity through the lens of the gut microbiome, providing a comprehensive overview of its role by addressing gut microbiome alterations, microbiome-driven mechanisms, dietary influences, prebiotic effects, microbiome-based therapeutics, and other approaches in the treatment of obesity and related metabolic disorders. The composition of the gut microbiome is altered in obesity and characterized by reduced microbial diversity and inconsistent shifts in dominant bacterial phyla, which collectively contribute to metabolic dysregulation. The gut microbiome influences obesity through multiple mechanisms. These include regulating energy balance and insulin sensitivity via short-chain fatty acids, inducing chronic inflammation, modulating metabolic and appetite genes, altering bile acid signaling, and promoting fat storage by inhibiting fasting-induced adipose factor. Dietary patterns exert a profound influence on gut microbiome composition and function, with plant-based diets conferring protective effects against obesity and its comorbidities. Microbiome-based therapeutics, including probiotics, synbiotics, and fecal microbiota transplantation, have demonstrated potential in modulating key metabolic and inflammatory pathways associated with obesity. As the scientific understanding of the human gut microbiome continues to advance, the integration of microbiome-based therapies into standard clinical practice is poised to become increasingly feasible and therapeutically transformative, particularly for obesity, a complex condition that demands innovative and customized interventions.
据估计，目前有26亿人超重或肥胖，预计到2035年这一数字将超过40亿。因此，除非有效解决这一上升趋势，否则预计这一趋势在未来几年还将持续。肠道微生物群已成为宿主代谢和能量稳态的核心调节因子，因此对其进行详细表征对于推进创新治疗策略以及阐明代谢健康和疾病的潜在机制至关重要。本综述从肠道微生物群的角度审视人类肥胖问题，通过探讨肠道微生物群的改变、微生物群驱动的机制、饮食影响、益生元作用、基于微生物群的治疗方法以及治疗肥胖和相关代谢紊乱的其他方法，全面概述其作用。肥胖时肠道微生物群的组成会发生改变，其特征是微生物多样性降低，优势细菌门的变化不一致，这些共同导致代谢失调。肠道微生物群通过多种机制影响肥胖。这些机制包括通过短链脂肪酸调节能量平衡和胰岛素敏感性、诱导慢性炎症、调节代谢和食欲基因、改变胆汁酸信号以及通过抑制禁食诱导的脂肪因子促进脂肪储存。饮食模式对肠道微生物群的组成和功能有深远影响，以植物为基础的饮食对肥胖及其合并症具有保护作用。基于微生物群的治疗方法，包括益生菌、合生元和粪便微生物群移植，已显示出调节与肥胖相关的关键代谢和炎症途径的潜力。随着对人类肠道微生物群的科学认识不断进步，将基于微生物群的疗法整合到标准临床实践中变得越来越可行，并具有治疗变革性，特别是对于肥胖这种需要创新和定制干预措施的复杂疾病。
