肠道菌群及其代谢物与骨代谢的关系及其潜在机制的研究进展

随着人口老龄化的发展，骨质疏松的发病率越来越高，其并发的骨折也给社会和家庭带来沉重的经济负担。近年来许多研究表明肠道菌群可影响机体骨代谢，其中涉及的可能机制大部分尚未明确。肠道菌群定植在人体肠道中，可通过发酵产生大量的代谢产物如短链脂肪酸（short chain fatty acids，SCFAs）、吲哚衍生物、多聚胺、腺苷三磷酸（adenosine triphosphate，ATP） 等，可能对骨代谢产生重要的影响。其中以短链脂肪酸的研究最多，短链脂肪酸可促进骨形成，其影响骨代谢的机制可能是通过促进胰岛素样生长因子1（insulin-like growth factor-1，IGF-1）、胰高血糖素样肽1（glucagon-like peptide-1，GLP-1）的分泌而间接起作用。此外，植物雌激素、膳食植物多酚对骨代谢具有保护作用，这些作用依赖肠道菌群的存在。肠道菌群可将植物雌激素、膳食植物多酚等分解为具有更大活性的代谢物，从而对骨代谢产生调控作用。本文通过对肠道菌群及其代谢物与骨质疏松的相关性研究进行综述，总结了肠道菌群代谢物的种类、与骨代谢的关系以及其调控骨代谢的潜在机制，为肠道菌群防治骨质疏松的进一步机制研究奠定基础。

Research progress of the relationship between gut microbiota and their metabolites and bone metabolism, and the potential mechanism

With the development of population aging, the incidence of osteoporosis is increasing, and its complication fracture has brought heavy economic burden to society and family. In recent years, many studies have shown that gut microbiota can affect bone metabolism, but the mechanisms is not yet clear. Through fermentation, gut microbiota in human intestine produces a large number of metabolites including short-chain fatty acid (SCFAs), indole derivatives, polyamines, adenosine triphosphate and so on, which may exert important influence on bone metabolism. Among them SCFAs is one of the most studied metabolites, which may promote bone formation by indirectly promoting insulin-like growth factor-1 (IGF-1) and glucagon-like peptide-1 (GLP-1) secretion. In addition, phytoestrogens and dietary plant polyphenols have protective effects on bone metabolism, which depend on the presence of gut microbiota. Gut microbiota can decompose phytoestrogens and dietary plant polyphenols into more active metabolites, which can regulate bone metabolism. We reviewed the relationship between gut microbiota and its metabolites and osteoporosis, summarized the types of gut microbiota metabolites, the relationship with bone metabolism and the potential mechanism of regulating bone metabolism, and thus laid a foundation for further research on the mechanism of gut microbiota in preventing and treating osteoporosis.