全球范圍內(nèi)肥胖和2型糖尿病（T2DM）的患病率正在以驚人的速度上升。腸道微生物在這些代謝紊亂疾病中的潛在作用目前已經(jīng)明確。研究表明，肥胖與腸道菌群的組成變化有關(guān)，肥胖者的微生物組成可能更高效率地從飲食中獲取能量。瘦的男性志愿者糞便移植（FMT）于罹患代謝綜合征的男性后可顯著提高代謝綜合征患者腸道微生物多樣性和胰島素敏感性，其中丁酸產(chǎn)生菌明顯增加。這些腸道菌群組成差異或可作為高危患者2型糖尿病病程發(fā)展的早期診斷標(biāo)志物。腸道微生物如丁酸產(chǎn)生菌可能通過(guò)基因表達(dá)和激素調(diào)節(jié)的不同途徑改善線粒體活性代謝，預(yù)防代謝性內(nèi)毒素血癥和激活腸道糖異生。未來(lái)的研究應(yīng)集中在細(xì)菌產(chǎn)物（如丁酸）是否具有與腸道細(xì)菌具有相同的效果，最終對(duì)肥胖和糖尿病進(jìn)行更成功干預(yù)。目前相關(guān)的技術(shù)正在迅速發(fā)展，包括使用糞便移植，已顯示出可喜的成果，是未來(lái)的微生物新療法的希望。該文章發(fā)表于Diabetes Care January 2015 vol. 38 no. 1159-165.

    摘要原文：

    Insights Into the Role of the Microbiome in Obesity and Type 2 DiabetesThe worldwide prevalence of obesity and type 2 diabetes mellitus （T2DM） continues to rise at an alarming pace. Recently the potential role of the gut microbiome in these metabolic disorders has been identified. Obesity is associated with changes in the composition of the intestinal microbiota, and the obese microbiome seems to be more efficient in harvesting energy from the diet. Lean male donor fecal microbiota transplantation （FMT） in males with metabolic syndrome resulted in a significant improvement in insulin sensitivity in conjunction with an increased intestinal microbial diversity, including a distinct increase in butyrate-producing bacterial strains. Such differences in gut microbiota composition might function as early diagnostic markers for the development of T2DM in high-risk patients. Products of intestinal microbes such as butyrate may induce beneficial metabolic effects through enhancement of mitochondrial activity, prevention of metabolic endotoxemia, and activation of intestinal gluconeogenesis via different routes of gene expression and hormone regulation. Future research should focus on whether bacterial products （like butyrate） have the same effects as the intestinal bacteria that produce it, in order to ultimately pave the way for more successful interventions for obesity and T2DM. The rapid development of the currently available techniques, including use of fecal transplantations, has already shown promising results, so there is hope for novel therapies based on the microbiota in the future.