腸道菌群和肥胖

腸道菌群和肥胖腸道菌群和肥胖肥胖的定義肥胖病一般被定義作為有BMI30以上。體重將近900磅(約400公斤)的里基(RickyNaputi)現(xiàn)年39歲，是世界最重的男子之一。因為體型過于笨重而難以移動，他已經(jīng)在坐落于太平洋關(guān)島的家中躺了五年之久。腸道菌群和肥胖是一個新的熱門話題肥胖和正常人AmandineEverard&PatriceD.Cani,Diabetes,obesityandgutmicrobiota.BestPractice&ResearchClinicalGastroenterology27(2013)73–83.史氏甲烷短桿菌和肥胖為了確定腸道菌群的改變和驗證人體腸道中的乳桿菌或雙歧桿菌是否與肥胖或消瘦相關(guān)，我們采用定量PCR和乳桿菌選擇性培養(yǎng)基分析了68位肥胖志愿者和47位對照的糞便菌群中硬壁菌、擬桿菌、乳酸乳球菌、動物雙歧桿菌和若干乳桿菌種的數(shù)量。結(jié)果：定量PCR試驗中，動物雙歧桿菌(OR=0.63;95%CI0.39-1.01;P=0.056)和史氏甲烷短桿菌(OR=0.76;95%CI0.59-0.97;P=0.03)與正常體重相關(guān)，而羅伊氏乳桿菌(OR=1.79;95%CI1.03-3.10;P=0.04)與肥胖相關(guān)。MillionM,etal.,Obesity-associatedgutmicrobiotaisenrichedinLactobacillusreuterianddepletedinBifidobacteriumanimalisandMethanobrevibactersmithii.IntJObes(Lond).2011Aug9.產(chǎn)甲烷肥胖的人有較高的身體質(zhì)量指數(shù)58人，BMI顯著較高的甲烷陽性者（±公斤/米2）比甲烷陰性（±公斤/米2，）。甲烷陽性者也有更大程度的便秘與甲烷相比，陰性者（±比±，P?=.043）。多元回歸分析說明了BMI甲烷之間有顯著的關(guān)系。結(jié)論：這是人類第一次有研究表明，較高濃度的甲烷檢測呼氣測試是預(yù)測顯著更大的肥胖超重者。等，肝臟病雜志胃腸病學(xué)雜志，2012年1月8（1）：22-28美國Cedars-Sinai醫(yī)學(xué)中心腸道菌群致肥胖原因ValentinaTremaroli&FredrikB?ckhed,Functionalinteractionsbetweenthegutmicrobiotaandhostmetabolism.NATURE|VOL489|13SEPTEMBER2012腸道菌群致肥胖原理GiulioGMuccioli,etal.,Theendocannabinoidsystemlinksgutmicrobiotatoadipogenesis.MolecularSystemsBiology6:392;p1-15.腸道菌群致肥胖原理JOHNK.DIBAISE,etal.,GutMicrobiotaandItsPossibleRelationshipWithObesity.MayoClinProc.2008;83(4):460-469.Obesityisassociatedwithphylum-levelchangesinthemicrobiota,reducedbacterialdiversityandalteredrepresentationofbacterialgenesandmetabolicpathways.Theseresultsdemonstratethatadiversityoforganismalassemblagescannonethelessyieldacoremicrobiomeatafunctionallevel,andthatdeviationsfromthiscoreareassociatedwithdifferentphysiologicalstates(obesecomparedwithlean).雙胞胎胖瘦菌群比較PeterJ.Turnbaugh,etal.,Acoregutmicrobiomeinobeseandleantwins.Nature,Vol457|22January2009|不同胖瘦人群腸道菌群數(shù)量FabriceArmougom,etal.,MonitoringBacterialCommunityofHumanGutMicrobiotaRevealsanIncreaseinLactobacillusinObesePatientsandMethanogensinAnorexicPatients.PLoSONE4(9):e7125.不同胖瘦人群腸道菌群種類FabriceArmougom,etal.,MonitoringBacterialCommunityofHumanGutMicrobiotaRevealsanIncreaseinLactobacillusinObesePatientsandMethanogensinAnorexicPatients.PLoSONE4(9):e7125.Thegutmicrobiotacompositionhasbeenassociatedwithseveralhallmarksofmetabolicsyndrome(e.g.,obesity,type2diabetes,cardiovasculardiseases,andnon-alcoholicsteatohepatitis).Growingevidencesuggeststhatgutmicrobescontributetotheonsetofthelow-gradeinflammationcharacterisingthesemetabolicdisordersviamechanismsassociatedwithgutbarrierdysfunctions.Recently,enteroendocrinecellsandtheendocannabinoidsystemhavebeenshowntocontrolgutpermeabilityandmetabolicendotoxaemia.Moreover,targetednutritionalinterventionsusingnondigestiblecarbohydrateswithprebioticpropertieshaveshownpromisingresultsinpre-clinicalstudiesinthiscontext,althoughhumaninterventionstudieswarrantfurtherinvestigations.Thesedataunderlinetheadvantageofinvestigatingandchangingthegutmicrobiotaasatherapeutictargetinthecontextofobesityandtype2diabetes.AmandineEverard&PatriceD.Cani,Diabetes,obesityandgutmicrobiota.BestPractice&ResearchClinicalGastroenterology27(2013)73–83.腸道菌群致代謝紊亂機理ThomasGreinerandFredrikBa¨ckhed.Effectsofthegutmicrobiotaonobesityandglucosehomeostasis.TrendsinEndocrinologyandMetabolism,April2011,Vol.22,No.4recentdatahaverevealedthatthegutmicrobiotacanaffectobesity.Thegutmicrobiotacontributestohostmetabolismbyseveralmechanismsincludingincreasedenergyharvestfromthediet,modulationoflipidmetabolism,alteredendocrinefunction,andincreasedinflammatorytone.Thegutmicrobiotacouldthusbeconsideredtobeanenvironmentalfactorthatmodulatesobesityandothermetabolicdiseases.腸道菌群致肥胖-糖尿病機理PatriceD.Cani,etal.,Involvementofgutmicrobiotainthedevelopmentoflow-gradeinflammationandtype2diabetesassociatedwithobesity.GutMicrobes3:4,279-288.無菌鼠定植后代謝路徑EmidioScarpellini,etal.,Gutmicrobiotaandobesity.InternEmergMed(2010)5(Suppl1):S53–S56.越來越多的證據(jù)表明腸道菌群與肥胖、膜島素抵抗等代謝性疾病的發(fā)生密切相關(guān)，具體分子機制也正被逐步揭示出來。腸道菌群不僅可調(diào)節(jié)能量代謝，促進脂肪過度積累，還是宿主全身性低度慢性炎癥和膜島素抵抗等代謝紊亂的誘發(fā)因素之一。腸道菌群有可能成為預(yù)防和治療肥胖癥的新靶點。趙立平和費娜，腸道菌群與肥胖癥的關(guān)系研究進展，微生物與感染

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菌群和肥胖胖人腸道菌群多樣化少TurnbaughPJ,etal.Acoregutmicrobiomeinobeseandleantwins.Nature2009;457:480–484.菌群和肥胖小老鼠研究：母親和子代之間、子代（親/表兄弟姐妹）之間的盲腸微生物區(qū)系各都具有相似的結(jié)構(gòu)組成，而無血緣關(guān)系的兩個小鼠家族之間的盲腸微生物區(qū)系在屬的水平上卻有顯著差異。腸道菌群和肥胖肥胖基因（ob基因），其突變也引起小鼠腸道優(yōu)勢微生物類群比例的顯著變化，并可能導(dǎo)致脂肪貯積和肥胖。Fiaffasting-inducedadipocytefactor，禁食脂肪細胞因子人體內(nèi)的細菌相比進食的多少而言，可能是導(dǎo)致肥胖的一個更重要的因素影響代謝的因素基因飲食菌群腸道菌群影響代謝FrederikBackhed,ProgrammingofHostMetabolismbytheGutMicrobiota.AnnNutrMetab2011;58(suppl2):44–52.腸道微生態(tài)肥胖管理一項引起世界關(guān)注的研究NCD:正常飲食，HFD:高脂飲食，LB:溶菌肉湯

NaFeiandLipingZhao,Anopportunisticpathogenisolatedfromthegutofanobesehumancausesobesityingermfreemice,TheISMEJournal(2013)7,880–884.Jia,Wetal.,(2008)Gutmicrobiota:apotentialnewterritoryfordrugtargeting,NatureReviewsDrugDiscovery.7:123-131.Jia,Wetal.,(2008)Gutmicr