电针对胰岛素抵抗肥胖大鼠肠道菌群的影响

[目的]观察电针对高脂饮食诱导的胰岛素抵抗肥胖大鼠肠道菌群结构和功能以及体重、进食量、胰岛素敏感性的影响,探讨电针改善胰岛素抵抗肥胖的机制。[方法]48只健康Wistar雄性大鼠,随机挑选8只喂以普通饲料作为正常组,其余40只喂以高脂饲料建立胰岛素抵抗肥胖模型。8周后,造模成功的大鼠随机分为模型组、电针组和假电针组,每组8只。电针组取穴:"丰隆""中脘""关元""足(后)三里"。假电针组给予穴旁5 mm处浅针刺,夹持电极,不通电。每次10 min,隔日一次,共治疗8周。分别在治疗前及治疗2、4、6、8周后测量所有大鼠的体重和24 h进食量;治疗结束后以高胰岛素-正葡萄糖钳夹术测定所有大鼠的胰岛素敏感性[用葡萄糖输注速率(GIR)表示];用ELISA法测定血清胰岛素水平;用宏基因组学检测技术检测肠道菌群的分布和特定菌群、代谢功能。[结果]治疗后,与正常组相比,模型组大鼠的24 h进食量、体重和血清胰岛素均显著升高(P<0.01),而GIR显著降低(P<0.01),模型组大鼠肠道拟杆菌门丰度明显减少、厚壁菌门丰度明显升高;且模型组大鼠的肠道菌群在一般功能预测、碳水化合物的转运与代谢、氨基酸的转运与代谢、能量的产生与转化、脂质的转运与代谢COG蛋白功能聚类均降低;与模型组和假电针组相比,电针组大鼠的24 h进食量、体重和血清胰岛素均显著降低(P<0.01),而GIR显著升高(P<0.01),拟杆菌门丰度有升高趋势,厚壁菌门丰度有降低趋势;电针组以上功能COG蛋白功能聚类均有上升趋势。属水平heatmap显示肠道菌群结构和丰度比较,电针组与正常组肠道菌群有相似性,模型组和假电针组肠道菌群也有相似性,但与电针组与正常组之间差异有统计学意义。COG聚类heatmap比较,电针组和正常组有相似性,模型组和假电针组也有相似性,但与电针组与正常组之间差异有统计学意义。[结论]电针可以有效调控胰岛素抵抗肥胖大鼠肠道菌群的结构和功能,可能是电针改善胰岛素抵抗肥胖的机制之一。     

肠道菌群代谢产物与胰岛素抵抗相关衰老疾病的研究进展

2型糖尿病(T2DM)和阿尔茨海默病(AD)都是与年龄相关的衰老性疾病,二者存在多种共同危险因素.肠道微生物通过多种代谢产物参与胰岛素生理机能的调控过程,在胰岛素抵抗(IR)发生发展中发挥重要的作用.该文从IR的角度,对肠道菌群代谢产物与T2DM及AD发病机制的内在联系作一综述.     

妊娠期糖尿病与肠道菌群改变的研究进展

［摘要］　妊娠期糖尿病（GDM）是妊娠常见并发症之一,表现为妊娠期糖代谢异常,对母儿造成长久的影响。妊娠期孕妇肠道菌群数量和种类出现生理性改变。研究表明,肠道菌群多样性及丰富度的改变是造成GDM发生发展的潜在因素。该文对GDM女性菌群改变的研究文献作一综述。     

胰岛素抵抗与心力衰竭关系的研究进展

胰岛素抵抗(IR)是指机体组织细胞对胰岛素的敏感性下降的一种状态。研究发现IR与心力衰竭(heart failure, HF)密切相关，IR可促进HF的发生发展，HF的加重也可反过来促进IR，IR和HF的恶性循环会不断导致HF的恶化和IR的加重。本文简要介绍了IR与心力衰竭关系的研究进展。     

达格列净对初诊2型糖尿病患者肠道菌群、胰岛素抵抗和胰岛β细胞功能的影响

目的 分析达格列净对初诊2型糖尿病患者肠道菌群、胰岛素抵抗和胰岛β细胞功能的影响。方法 便利选取2021年6月—2022年5月在福建省汀州医院接受治疗的56例初诊2型糖尿病患者为研究对象,以患者就诊顺序进行编号,根据随机数表法分为对照组和研究组,每组28例。对照组应用二甲双胍治疗,研究组给予达格列净治疗。比较两组患者的肠道菌群数量、血糖、血脂及胰岛功能。结果 治疗后,两组患者酵母菌、肠球菌、肠杆菌数量均明显低于治疗前,乳杆菌、拟杆菌以及双歧杆菌数量均明显高于治疗前,且研究组的上述指标均明显优于对照组,差异有统计学意义（P<0.05）。治疗后,两组患者空腹血糖、糖化血红蛋白、空腹胰岛素、低密度脂蛋白胆固醇、三酰甘油、总胆固醇均低于治疗前,高密度脂蛋白胆固醇高于治疗前,差异有统计学意义（P<0.05）,但治疗前后的组间比较,差异无统计学意义（P>0.05）。治疗后,两组患者胰岛素β细胞功能指数高于治疗前,胰岛素抵抗指数低于治疗前,且研究组均优于对照组,差异有统计学意义（P<0.05）。两组不良反应发生率比较,差异无统计学意义（P>0.05）。结论 达格列净对初...     

腺苷酸活化蛋白激酶与胰岛素抵抗

哺乳动物组织中，腺苷酸活化蛋白激酶（AMPK）是细胞内重要的能量代谢感受器，属于代谢敏感性蛋白激酶家族。它是调节多种代谢过程的重要信号分子，对于糖脂代谢尤有积极的调节作用。有证据表明，在抗糖尿病药物中，二甲双胍和噻唑烷二酮类药物均是通过激活AMPK而发挥胰岛素增敏作用的。     

肠道菌群与心血管疾病

肠道菌群是一个数量庞大种类繁多的复杂生态系统,参与调节物质和能量代谢、机体免疫、组织器官发育等重要的生理过程,其结构和功能的稳态失调参与高血压、动脉粥样硬化、冠心病、心肌梗死、心力衰竭以及心律失常等心血管疾病的发生发展。本文旨在阐明肠道菌群及相关代谢产物与心血管疾病研究的新进展,为心血管疾病的防治提供新的思路,为未来开展肠道菌群与心血管疾病的研究指明发展方向。     

吸烟与胰岛素抵抗

吸烟可使健康人及糖尿病患者胰岛素敏感性受到急性或慢性损害，导致或加重胰岛素抵制。本文重点介绍目前对吸烟与胰岛素抵抗的研究概况。     

胰岛素抵抗与糖尿病心肌病的研究进展

一、概述 糖尿病心肌病(DC)最早是由Rubler等~([1])于1972提出的.DC的可能病因包括代谢紊乱、胰岛素抵抗(IR)、心脏小血管病变、心脏自主神经系统的紊乱、心肌纤维,凋亡及坏死等,其中IR在DC的发生发展过程中起重要作用,最终导致心肌细胞肥大、心肌间质纤维化、胶原沉积等病理变化.因此,DC的治疗可结合已有的有关DC的研究成果,并以其特有的发病机制为靶点,早期干预并逆转代谢异常对心肌的毒性作用将是防治DC的有效手段.     

胰岛素抵抗综合征防治进展——胰岛素抵抗与冠心病

流行病学研究证明 ,空腹血浆胰岛素水平升高是冠心病的一个独立预测指标 ,且在非糖尿病个体中尤甚。胰岛素抵抗 (IR)及其代偿性的高胰岛素血症 ,可明显增加个体冠心病的危险性 ,这是因为IR与内皮细胞损伤、平滑肌细胞增殖有密切关系。正常情况下 ,胰岛素作用于血管内皮细胞 ,产生一氧化氮 ,并刺激前列腺素释放 ,抑制内皮素释放 ,使血管扩张。IR时患者内皮细胞功能障碍 ,凝血系统激活 ,纤溶系统受抑制 ,可致脂质沉积、血栓形成和血管平滑肌增殖。巨噬细胞和纤维组织在血管内膜下形成脂肪纹 ,进一步发展为粥样硬化斑块 ,致血管壁增厚 ,管腔…     

胰升血糖素与肝源性胰岛素抵抗

肝源性IR是T2DM重要发病基础之一,机制主要为受体缺陷及信号转导异常。作为对抗胰岛素的重要激素,胰升血糖素在糖尿病发病中起重要作用。与健康人群比,糖尿病患者或动物存在胰岛素异常分泌,也存在胰升血糖素异常高分泌。胰升血糖素在肝源性IR中的作用主要为抑制肝糖原合成及糖酵解,促进肝糖原分解、糖异生及脂肪分解。     

Gut microbiota in autism and mood disorders

The hypothesis of an important role of gut microbiota in the maintenance of physiological state into the gastrointestinal (GI) system is supported by several studies that have shown a qualitative and quantitative alteration of the intestinal flora in a number of gastrointestinal and extra-gastrointestinal diseases. In the last few years, the importance of gut microbiota impairment in the etiopathogenesis of pathology such as autism, dementia and mood disorder, has been raised. The evidence of the inflammatory state alteration, highlighted in disorders such as schizophrenia, major depressive disorder and bipolar disorder, strongly recalls the microbiota alteration, highly suggesting an important role of the alteration of GI system also in neuropsychiatric disorders. Up to now, available evidences display that the impairment of gut microbiota plays a key role in the development of autism and mood disorders. The application of therapeutic modulators of gut microbiota to autism and mood disorders has been experienced only in experimental settings to date, with few but promising results. A deeper assessment of the role of gut microbiota in the development of autism spectrum disorder (ASD), as well as the advancement of the therapeutic armamentarium for the modulation of gut microbiota is warranted for a better management of ASD and mood disorders.     

肠道菌群与1型糖尿病

T1DM是一种常见的自身免疫疾病,但其发病机制尚未完全明确.近年来的研究发现,肠道菌群紊乱可能通过改变肠壁通透性及免疫功能参与了T1DM的进程.使用一些抗生素或益生菌有助于维持肠道菌群的平衡,延缓T1DM的发展,为研究T1DM的发病机制及治疗开阔思路.     

Gut microbiota in obesity

Obesity is a major global health problem determined by heredity and environment, and its incidence is increasing yearly. In recent years, increasing evidence linking obesity to the gut microbiota has been reported. Gut microbiota management has become a new method of obesity treatment. However, the complex interactions among genetics, environment, the gut microbiota, and obesity remain poorly understood. In this review, we summarize the characteristics of the gut microbiota in obesity, the mechanism of obesity induced by the gut microbiota, and the influence of genetic and environmental factors on the gut microbiota and obesity to provide support for understanding the complex relationship between obesity and microbiota. At the same time, the prospect of obesity research related to the gut microbiota is proposed.     

Gut microbiota imbalance and colorectal cancer

The gut microbiota acts as a real organ. The symbiotic interactions between resident micro-organisms and the digestive tract highly contribute to maintain the gut homeostasis. However, alterations to the microbiome caused by environmental changes(e.g., infection, diet and/or lifestyle) can disturb this symbiotic relationship and promote disease, such as inflammatory bowel diseases and cancer. Colorectal cancer is a complex association of tumoral cells, non-neoplastic cells and a large amount of micro-organisms, and the involvement of the microbiota in colorectal carcinogenesis is becoming increasingly clear. Indeed, many changes in the bacterial composition of the gut microbiota have been reported in colorectal cancer, suggesting a major role of dysbiosis in colorectal carcinogenesis. Some bacterial species have been identified and suspected to play a role in colorectal carcinogenesis, such as Streptococcus bovis, Helicobacter pylori, Bacteroides fragilis, Enterococcus faecalis, Clostridium septicum, Fusobacterium spp. and Escherichia coli. The potential pro-carcinogenic effects of these bacteria are now better understood. In this review, we discuss the possible links between the bacterial microbiota and colorectal carcinogenesis, focusing on dysbiosis and the potential pro-carcinogenic properties of bacteria, such as genotoxicity and other virulence factors, inflammation, host defenses modulation, bacterial derived metabolism, oxidative stress and anti-oxidative defenses modulation. We lastly describe how bacterial microbiota modifications could represent novel prognosis markers and/or targets for innovative therapeutic strategies.     

高血清胰岛素样生长因子结合蛋白7血症与胰岛素抵抗的相关性研究

目的 研究T2DM患者血清胰岛素样生长因子结合蛋白7（IGFBP7）与坂的相关性。方法选取新诊断T2DM患者（T2DM组）137例和健康体检者（NC组）96名,测定两组FPG、FInS、血脂、C-RP、肿瘤坏死因子a（TNF-a）和IGFBP7。结果T2DM组除TC和LDL-C外,其余指标与NC组比较差异有统计学意义（P〈0．05）。按T2DM组IGFBP7四分位数将其分成4组（Q1～4）,各组间年龄、BMI、C-RP、TNF-a、Fins、HOMA-IR和HOMA-IS差异有统计学意义（P＜0．05）;新诊断T2DM患者IpFBP7与年龄、BMI、C-RP、TNF-a、Fins和HOMA-IR呈正相关（r=0．264、0．173、0．255、0．227、0．192、0．325,P〈0．05）,与HOMA-IS呈负相关（r=-0．324,P〈0．01）。年龄、C-RP、TNF-n和HOMA-IR是影响新诊断T2DM患者IGFBP7水平的独立因素（β’=0．318、0．186、0．239、0．255,P〈0．05）。结论新诊断T2DM患者IGFBP7与年龄、C-RP、TNF-a和HOMA-IR密切相关。     

Gut microbiota profile in healthy Indonesians

BACKGROUND Recently, gut microbiota has been associated with various diseases other than intestinal disease. Thus, there has been rapid growth in the study of gut microbiota. Considering the numerous factors influencing gut microbiota such as age, diet, etc., area-based research is required. Indonesia has numerous different tribes and each of these tribes have different lifestyles. Hence, it is expected that each tribe has a specific gut microbiota. A deeper insight into the composition of gut microbiota can be used to determine the condition of gut microbiota in Indonesians and to consider which treatment may be suitable and effective to improve health status.AIM To investigate the gut microbiota of Indonesian subjects represented by Javanese and Balinese tribes by analyzing fecal samples.METHODS Fecal samples were collected from a total of 80 individuals with 20 in each of the young groups ranging from 25-45 years and the elderly group aged 70 years or more from two different regions, Yogyakarta and Bali. Fecal sample collection was performed at the end of the assessment period(day 14 ± 1 d) during which time the subjects were not allowed to consume probiotic or antibiotic products.The quantification of various Clostridium subgroups, Lactobacillus subgroups,Enterococcus, Streptococcus, Staphylococcus, Bacteroides fragilis group and Prevotella,Bifidobacterium and Atopobium cluster, Enterobacteriaceae and Pseudomonas was performed using the Yakult intestinal flora-scan(YIF-SCAN).RESULTS The bacterial population in younger subjects' feces was higher than that in the elderly population, with a total of approximately 10.0 – 10.6 log10 bacterial cells/g feces. The most abundant bacteria in all groups were Clostridium, followed by Prevotella, Atopobium, Bifidobacterium and Bacteroides. In the elderly, an increase in Enterobacteriaceae, Coliform and Escherichia coli was found. In terms of bacterial counts in Yogyakarta, total bacteria, Clostridium coccoides(C. coccoides) group,Bifidobacterium, Prevotella, Lactobacillus plantarum subgroup, and Streptococcus were significantly higher(P < 0.05) in younger than elderly subjects, while the Lactobacillus gasseri subgroup, Lactobacillus casei subgroup, and Lactobacillus reuteri subgroup counts were significantly lower(P < 0.05) in younger subjects. In Balinese subjects, total bacteria, C. coccoides group, Clostridium leptum subgroup,Bacteroides fragilis group, and Prevotella were significantly higher(P < 0.05) in younger compared to elderly individuals, while the Lactobacillus ruminis subgroup, and Enterobacteriaceae were significantly lower(P < 0.05) in younger subjects. The results also revealed that, besides the C. coccoides group and Clostridium leptum group being the most abundant gut microbiota in both Yogyakarta and Balinese people, the latter was indicated by a higher Clostridium perfringens count, which was almost 10 times that of Yogyakarta subjects. This may be a response to different lifestyles in the different tribes; however, this phenomenon requires further extensive study.CONCLUSION Bacterial populations were higher in younger than in elderly subjects. Most abundant bacterial groups were Clostridium, Prevotella, Atopobium, Bifidobacterium,and Bacteroides. The level of Clostridium perfringens in Yogyakarta subjects was lower than that in Balinese subjects.     

糖耐量减低患者维生素D、维生素D受体基因FokI多态性与胰岛素抵抗的相关性研究

目的 探讨IGT者25羟基维生素D3（25-OH-VD3）、维生素D受体（VDR）基因FokI多态性与IR的相关性。 方法 选取IGT者（IGT组）94例及正常对照（NC）组54名,采用PCR-RLFP检测VDR基因FokI多态性,ELISA检测25-OH-VD3,比较各组基因型及等位基因频率。 结果 ⑴与NC组比较,IGT组血清25-OH-VD3较低[（22.05±2.37） vs （32.04± 2.64） ng/ml,P〈0.05];⑵与NC比较,IGT组“f”等位基因频率升高（46.8% vs 25.9%,FF：30.9% vs 57.4%;Ff： 46.9% vs 33.3%;ff：22.3% vs 9.3%,P〈0.05）。与FF基因型比较,Ff/ff基因型患IGT危险增加（OR=2.613,95%CI=1.239～5.512,P=0.018;OR=4.490,95%CI=1.496～13.473,P=0.010）。与F型比较,携带“f”等位基因患IGT风险增加（OR=2.465,95%CI=1.188～5.116,P=0.023）。Ff、ff基因型与FF型比较,HOMA-IR增高（P〈0.05）;VDR基因FokI位点ff基因型者较其它两种基因型IR更明显（P〈0.01）;⑶Logistic回归分析显示,VDR基因FokI ff与IR呈正相关（OR=1.761,95%CI：1.050～2.970,P〈0.05）,25-OH-VD3与IR呈负相关（β=-1.187,OR=0.461,95%CI：0.187～0.741,P〈0.05）。 结论 血清25-OH-VD3水平与IR呈负相关,VDR基因FokI可能与IGT者IR有关。