胆汁酸代谢与2型糖尿病的研究进展

胆汁酸（bile acids, BA）在肝脏中合成，是胆固醇的代谢产物。进食时，BA随胆汁进入肠道，其中95%的胆盐可被肠道（主要在回肠）重吸收入肝，以保持胆盐池的稳定。BA作为一种代谢调节因子，能够激活多种核受体和膜受体介导的信号通路，参与多种代谢调节过程，不仅可以促进食物中脂类的消化吸收，还参与糖脂及能量的代谢，同时BA谱又是代谢稳态的关键调节剂。BA代谢和信号转导的改变与肥胖和2型糖尿病（type 2 diabetes mellitus, T2DM）相关。BA螯合剂治疗的T2DM患者或进行减肥手术的病态肥胖患者，其血糖水平的显著改善均与BA谱和信号转导的变化有关。本文就BA的代谢调节通路与T2DM相关性进行综述。

Research progress on relationship between bile acid metabolism and type 2 diabetes mellitus

Bile acids (BAs) are metabolites of cholesterol that are synthesized in the liver. When eating, BAs are discharged to the intestines with bile, and 95% of the BAs can be reabsorbed into the liver by the intestines (mainly in the ileum) to keep the bile salt pool stable. In recent years, studies have shown that BAs, as a metabolic regulator, can activate a variety of nuclear receptors and membrane receptor-mediated signaling pathways, participate in metabolic regulation processes. In this sense BAs not only promote the digestion and absorption of lipids in the diet, but also participates in the metabolism of glycolipids and energy as a key regulator of metabolic homeostasis. Alterations in BA metabolism and signaling are associated with obesity and type 2 diabetes mellitus (T2DM), whereas treatment of T2DM patients with BA sequestrants, or bariatric surgery in morbidly obese patients, results in a significant improvement in glycemic response that is associated with changes in the BA profile and signaling. This article summarizes the study of the association between the metabolic regulation pathway of BAs and type 2 diabetes mellitus (T2DM).