Diabetes Care:长期服用二甲双胍对肠道微生物组成和循环短链脂肪酸的影响

2021-07-23 MedSci原创 MedSci原创

二甲双胍持续治疗6个月和12个月,会改变肠道微生物群组成

新的证据表明,世界上最常用的降糖药物二甲双胍的生物学效应起源于肠道。肠道是二甲双胍的主要储存库,在空肠中的蓄积量是血浆的30-300倍

本研究旨在确定二甲双胍治疗和行为性减肥对肠道微生物群和短链脂肪酸 (SCFA) 的长期影响。

这是一项包含了3个平行臂的随机试验,招募了接受怪异实体瘤治疗但未进行过癌症治疗的超重/肥胖成年人(n=121),随机分至1)二甲双胍组(高达2000 mg),2)教练指导的行为性减肥组,3)自我指导的护理组(对照),持续干预12个月。在基线(n=114)、6个月(n=109)和12个月(n=105)时收集受试者的粪便和血清。从粪便中提取微生物 DNA 并进行扩增和宏基因组测序,还检测了空腹血清中的SCFA和其他生化参数。

各组肠道微生物群组成在第6个月和12个月时的变化

在121位受试者中,79%的是女性,46%的是黑种人,平均60岁。只有二甲双胍治疗组受试者的微生物群组成发生了显著改变与对照组相比,在6个月和12个月时,二甲双胍治疗增加了大肠杆菌和扭链瘤胃球菌的扩增子序列的变异量,减少了Intestinibacter bartlettii的扩增子序列的变异量;还减少了12个月时氏菌属(包括屎肠球菌和R. intestinalis)的扩增子序列的变异量。

各组血清SCFA的变化

与对照组相比,二甲双胍治疗还增加了第6个月时血清的丁酸盐、醋酸盐和戊酸盐,但12个月时这些盐未见增加。醋酸盐的增加与空腹胰岛素的减少有关。对二甲双胍组的一个子集进行的额外全基因组宏基因组测序表明,二甲双胍改变了62条宏基因组功能通路,包括一条产生醋酸盐的通路和3条葡萄糖代谢通路。

综上所述,二甲双胍持续治疗6个月和12个月,会改变肠道微生物群组成,但行为性减肥无此效应。二甲双胍和行为性减肥均可改变6个月时的血清SCFA,包括醋酸盐增加(与空腹胰岛素降低有关)。

原始出处:

Noel T. Mueller, et al. Metformin Affects Gut Microbiome Composition and Function and Circulating Short-Chain Fatty Acids: A Randomized Trial. Diabetes Care 2021 Jul; 44(7): 1462-1471.

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    2021-07-24 misszhang

    二甲双胍,神药!

    0

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