临床荟萃 ›› 2024, Vol. 39 ›› Issue (5): 455-459.doi: 10.3969/j.issn.1004-583X.2024.05.012
延天美1,2a, 吴亚楠2a,3, 梁鹏2b, 魏立民2a()
收稿日期:
2023-02-23
出版日期:
2024-05-20
发布日期:
2024-07-05
通讯作者:
魏立民,Email: 基金资助:
Received:
2023-02-23
Online:
2024-05-20
Published:
2024-07-05
摘要:
由于现代人们生活水平的提高,日常久坐的不良习惯,及各种高热量食物的摄取,导致了在过去半个世纪里,肥胖的发生率急剧上升,肥胖及由肥胖引发的系列问题成为严重的公共健康问题。然而传统的减重方法并未达到理想的效果,目前已有研究表明,肥胖可能与人类肠道微生物群的构成有关,已有研究将肠道微生物移植用于肥胖患者,并且取得了一定的成果,本文综述了粪便微生物移植治疗肥胖的可行性及优越性,旨在为肥胖患者提供新的减重方案。
中图分类号:
延天美, 吴亚楠, 梁鹏, 魏立民. 粪便微生物移植:肥胖患者减重的新方案[J]. 临床荟萃, 2024, 39(5): 455-459.
[1] | 中国超重/肥胖医学营养治疗指南(2021)[J]. 中国医学前沿杂志(电子版), 2021, 13(11):1-55. |
[2] |
Gérard P. Gut microbiota and obesity[J]. Cell Mol Life Sci, 2016, 73(1): 147-162.
doi: 10.1007/s00018-015-2061-5 pmid: 26459447 |
[3] | 肥胖症基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2020(2):95-101. |
[4] |
Kaw R, Wong J, Mokhlesi B. Obesity and obesity hypoventilation, sleep hypoventilation, and postoperative respiratory failure[J]. Anesth Analg, 2021, 132(5): 1265-1273.
doi: 10.1213/ANE.0000000000005352 pmid: 33857968 |
[5] |
Peters U, Dixon AE, Forno E. Obesity and asthma[J]. J Allergy Clin Immunol, 2018, 141(4): 1169-1179.
doi: S0091-6749(18)30282-3 pmid: 29627041 |
[6] | Piché ME, Tchernof A, Després JP. Obesity phenotypes, diabetes, and cardiovascular diseases[J]. Circ Res, 2020, 126(11): 1477-1500. |
[7] | Ahmed B, Sultana R, Greene MW. Adipose tissue and insulin resistance in obese[J]. Biomed Pharmacother, 2021, 137(6-7): 111315. |
[8] |
Rhea EM, Salameh TS, Logsdon AF, et al. Blood-brain barriers in obesity[J]. Aaps j, 2017, 19(4): 921-930.
doi: 10.1208/s12248-017-0079-3 pmid: 28397097 |
[9] | Avgerinos KI, Spyrou N, Mantzoros CS, et al. Obesity and cancer risk: Emerging biological mechanisms and perspectives[J]. Metabolism, 2019, 92: 121-135. |
[10] |
Purdy JC, Shatzel JJ. The hematologic consequences of obesity[J]. Eur J Haematol, 2021, 106(3): 306-319.
doi: 10.1111/ejh.13560 pmid: 33270290 |
[11] |
Withrow D, Alter DA. The economic burden of obesity worldwide: A systematic review of the direct costs of obesity[J]. Obes Rev, 2011, 12(2): 131-141.
doi: 10.1111/j.1467-789X.2009.00712.x pmid: 20122135 |
[12] | Chao AM, Quigley KM, Wadden TA. Dietary interventions for obesity: Clinical and mechanistic findings[J]. J Clin Invest, 2021, 131(1). |
[13] |
Swift DL, Mcgee JE, Earnest CP, et al. The effects of exercise and physical activity on weight loss and maintenance[J]. Prog Cardiovasc Dis, 2018, 61(2): 206-213.
doi: S0033-0620(18)30144-0 pmid: 30003901 |
[14] |
Türk Y, Theel W, Kasteleyn MJ, et al. High intensity training in obesity: A meta-analysis[J]. Obes Sci Pract, 2017, 3(3): 258-271.
doi: 10.1002/osp4.109 pmid: 29071102 |
[15] |
Wadden TA, Tronieri JS, Butryn ML. Lifestyle modification approaches for the treatment of obesity in adults[J]. Am Psychol, 2020, 75(2): 235-251.
doi: 10.1037/amp0000517 pmid: 32052997 |
[16] | Butryn ML, Webb V, Wadden TA. Behavioral treatment of obesity[J]. Psychiatr Clin North Am, 2011, 34(4): 841-859. |
[17] | Swamy GM, Meriga B, Dasari S, et al. Recent Developments in the Prevention of Obesity by Using Microorganisms[J]. Recent Developments in Applied Microbiology and Biochemistry, 2019:47-60. |
[18] |
Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: A systematic review of the literature[J]. J Am Diet Assoc, 2011, 111(1): 92-102.
doi: 10.1016/j.jada.2010.10.008 pmid: 21185970 |
[19] | 蒋亮, 汤旭磊, 关聪会, 等. 肥胖的药物治疗进展[J]. 中国临床药理学杂志, 2021, 37(14): 1923-1927. |
[20] | 覃潆玉, 刘佳瑞, 郑瑞茂. 肥胖治疗的研究进展[J]. 生理科学进展, 2020, 51(3): 167-173. |
[21] | 黄秋菊, 李玉兰. 奥利司他疗效研究及不良反应[J]. 现代医药卫生, 2018, 34(19): 3025-3027. |
[22] | 白洁, 陶凯雄. 肥胖的减重代谢手术治疗[J]. 临床内科杂志, 2020, 37(9): 624-626. |
[23] | 侯睿. 我国代谢手术缓解肥胖2型糖尿病的研究概况[J]. 中国临床医生杂志, 2022, 50(7): 789-793. |
[24] |
Burgos AM, Braghetto I, Csendes A, et al. Gastric leak after laparoscopic-sleeve gastrectomy for obesity[J]. Obes Surg, 2009, 19(12): 1672-1677.
doi: 10.1007/s11695-009-9884-9 pmid: 19506979 |
[25] |
Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity[J]. Surg Endosc, 2006, 20(6): 859-863.
pmid: 16738970 |
[26] | Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults[J]. Cochrane Database Syst Rev, 2014, 2014(8): Cd003641. |
[27] |
Sethi M, Chau E, Youn A, et al. Long-term outcomes after biliopancreatic diversion with and without duodenal switch: 2-, 5-, and 10-year data[J]. Surg Obes Relat Dis, 2016, 12(9): 1697-1705.
doi: S1550-7289(16)00096-4 pmid: 27425842 |
[28] |
De Clercq NC, Groen AK, Romijn JA, et al. Gut microbiota in obesity and undernutrition[J]. Adv Nutr, 2016, 7(6): 1080-1089.
doi: 10.3945/an.116.012914 pmid: 28140325 |
[29] | Torres-Fuentes C, Schellekens H, Dinan TG, et al. The microbiota-gut-brain axis in obesity[J]. Lancet Gastroenterol Hepatol, 2017, 2(10): 747-756. |
[30] |
Boulangé CL, Neves AL, Chilloux J, et al. Impact of the gut microbiota on inflammation, obesity, and metabolic disease[J]. Genome Med, 2016, 8(1): 42.
doi: 10.1186/s13073-016-0303-2 pmid: 27098727 |
[31] | Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice[J]. Science, 2013, 341(6150): 1241214. |
[32] | Turnbaugh PJ, Hamady M, Yatsunenko T, et al. A core gut microbiome in obese and lean twins[J]. Nature, 2009, 457(7228): 480-484. |
[33] |
Zhang Y, Ge X, Heemstra LA, et al. Loss of FXR protects against diet-induced obesity and accelerates liver carcinogenesis in ob/ob mice[J]. Mol Endocrinol, 2012, 26(2): 272-280.
doi: 10.1210/me.2011-1157 pmid: 22261820 |
[34] |
Thomas C, Gioiello A, Noriega L, et al. TGR5-mediated bile acid sensing controls glucose homeostasis[J]. Cell Metab, 2009, 10(3): 167-177.
doi: 10.1016/j.cmet.2009.08.001 pmid: 19723493 |
[35] | Bäckhed F, Ding H, Wang T, et al. The gut microbiota as an environmental factor that regulates fat storage[J]. Proc Natl Acad Sci U S A, 2004, 101(44): 15718-15723. |
[36] | Samuel BS, Shaito A, Motoike T, et al. Effects of the gut microbiota on host adiposity are modulated by the short-chain fatty-acid binding G protein-coupled receptor, Gpr41[J]. Proc Natl Acad Sci U S A, 2008, 105(43): 16767-16772. |
[37] |
Nonogaki K, Kaji T. Pharmacological stimulation of serotonin 5-HT1B receptors enhances increases in plasma active glucagon-like peptide-1 levels induced by dipeptidyl peptidase-4 inhibition independently of feeding in mice[J]. Diabetes Metab, 2015, 41(5): 425-428.
doi: 10.1016/j.diabet.2015.06.005 pmid: 26234524 |
[38] | Dumas ME, Barton RH, Toye A, et al. Metabolic profiling reveals a contribution of gut microbiota to fatty liver phenotype in insulin-resistant mice[J]. Proc Natl Acad Sci U S A, 2006, 103(33): 12511-12516. |
[39] |
Cani PD, Amar J, Iglesias MA, et al. Metabolic endotoxemia initiates obesity and insulin resistance[J]. Diabetes, 2007, 56(7): 1761-1772.
doi: 10.2337/db06-1491 pmid: 17456850 |
[40] |
Neal MD, Leaphart C, Levy R, et al. Enterocyte TLR4 mediates phagocytosis and translocation of bacteria across the intestinal barrier[J]. J Immunol, 2006, 176(5): 3070-3079.
pmid: 16493066 |
[41] | Ridlon JM, Kang DJ, Hylemon PB, et al. Bile acids and the gut microbiome[J], 2014, 30(3): 332-338. |
[42] |
Schellekens H, Dinan TG, Cryan JF. Lean mean fat reducing "ghrelin" machine: Hypothalamic ghrelin and ghrelin receptors as therapeutic targets in obesity[J]. Neuropharmacology, 2010, 58(1): 2-16.
doi: 10.1016/j.neuropharm.2009.06.024 pmid: 19573543 |
[43] | Perry RJ, Peng L, Barry NA, et al. Acetate mediates a microbiome-brain-β-cell axis to promote metabolic syndrome[J]. Nature, 2016, 534(7606): 213-217. |
[44] |
Xu Y, Jones JE, Kohno D, et al. 5-HT2CRs expressed by pro-opiomelanocortin neurons regulate energy homeostasis[J]. Neuron, 2008, 60(4): 582-589.
doi: 10.1016/j.neuron.2008.09.033 pmid: 19038216 |
[45] | Delgado TC. Glutamate and GABA in appetite regulation[J]. Front Endocrinol (Lausanne), 2013, 4: 103. |
[46] |
Torres-Fuentes C, Schellekens H, Dinan TG, et al. A natural solution for obesity: Bioactives for the prevention and treatment of weight gain. A review[J]. Nutr Neurosci, 2015, 18(2): 49-65.
doi: 10.1179/1476830513Y.0000000099 pmid: 24621068 |
[47] |
Lee P, Yacyshyn BR, Yacyshyn MB. Gut microbiota and obesity: An opportunity to alter obesity through faecal microbiota transplant (FMT)[J]. Diabetes Obes Metab, 2019, 21(3): 479-490.
doi: 10.1111/dom.13561 pmid: 30328245 |
[48] | Wang JW, Kuo CH, Kuo FC, et al. Fecal microbiota transplantation: Review and update[J]. J Formos Med Assoc, 2019, 118 Suppl 1: S23-s31. |
[49] |
Mcevoy R. Bowel-flora alteration: A potential cure for inflammatory bowel disease and irritable bowel syndrome?[J]. Med J Aust, 1989, 151(2): 112.
doi: 10.5694/j.1326-5377.1989.tb101176.x pmid: 2783226 |
[50] |
Colman RJ, Rubin DT. Fecal microbiota transplantation as therapy for inflammatory bowel disease: A systematic review and meta-analysis[J]. J Crohns Colitis, 2014, 8(12): 1569-1581.
doi: 10.1016/j.crohns.2014.08.006 pmid: 25223604 |
[51] |
Pinn DM, Aroniadis OC, Brandt LJ. Is fecal microbiota transplantation the answer for irritable bowel syndrome? A single-center experience[J]. Am J Gastroenterol, 2014, 109(11): 1831-1832.
doi: 10.1038/ajg.2014.295 pmid: 25373585 |
[52] | Eiseman B, Silen W, Bascom GS, et al. Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis[J]. Surgery, 1958, 44(5): 854-859. |
[53] |
Choi HH, Cho YS. Fecal microbiota transplantation: Current applications, effectiveness, and future perspectives[J]. Clin Endosc, 2016, 49(3): 257-265.
doi: 10.5946/ce.2015.117 pmid: 26956193 |
[54] | Turnbaugh PJ, Ley RE, Mahowald MA, et al. An obesity-associated gut microbiome with increased capacity for energy harvest[J]. Nature, 2006, 444(7122): 1027-1031. |
[55] | Allegretti JR, Kassam Z, Mullish BH, et al. Effects of fecal microbiota transplantation with oral capsules in obese patients[J]. Clin Gastroenterol Hepatol, 2020, 18(4): 855-863.e2. |
[56] | Leong KSW, Jayasinghe TN, Wilson BC, et al. Effects of fecal microbiome transfer in adolescents with obesity: The gut bugs randomized controlled trial[J]. JAMA Netw Open, 2020, 3(12): e2030415. |
[57] | Ng SC, Xu Z, Mak JWY, et al. Microbiota engraftment after faecal microbiota transplantation in obese subjects with type 2 diabetes: A 24-week, double-blind, randomised controlled trial[J]. Gut, 2022, 71(4): 716-723. |
[58] |
Vrieze A, Van Nood E, Holleman F, et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome[J]. Gastroenterology, 2012, 143(4): 913-6.e7.
doi: 10.1053/j.gastro.2012.06.031 pmid: 22728514 |
[59] |
Kootte RS, Levin E, Salojärvi J, et al. Improvement of insulin sensitivity after lean donor feces in metabolic syndrome is driven by baseline intestinal microbiota composition[J]. Cell Metab, 2017, 26(4): 611-619.e6.
doi: S1550-4131(17)30559-4 pmid: 28978426 |
[60] | Wu Z, Zhang B, Chen F, et al. Fecal microbiota transplantation reverses insulin resistance in type 2 diabetes: A randomized, controlled, prospective study[J]. Front Cell Infect Microbiol, 2022, 12: 1089991. |
[1] | 王淑亮, 苏永峰. 肠道菌群在2型糖尿病中的研究进展[J]. 临床荟萃, 2024, 39(3): 274-278. |
[2] | 张晓璐, 李红山. 自身免疫性肝炎发病机制研究进展——聚焦“肠道菌群与免疫系统相互作用”[J]. 临床荟萃, 2024, 39(2): 177-182. |
[3] | 杨小雄, 杨帆, 魏小果. 肠-微生物群-肝轴与代谢相关脂肪性肝病的研究进展[J]. 临床荟萃, 2023, 38(6): 559-563. |
[4] | 江黎晨, 章秋, 胡红琳. Apelin在多囊卵巢综合征中的研究进展[J]. 临床荟萃, 2023, 38(3): 285-288. |
[5] | 任玉梅, 章秋, 胡红琳. 多囊卵巢综合征患者血清S100A4水平变化及其对多囊卵巢综合征的影响[J]. 临床荟萃, 2023, 38(12): 1078-1085. |
[6] | 赵丽岩, 康玮, 王庆周, 李博鹏, 曹亚薇, 李俊粉, 邵亮, 王康. 脂质蓄积指数、内脏脂肪指数对2型糖尿病患者一级亲属糖代谢的影响[J]. 临床荟萃, 2022, 37(9): 804-807. |
[7] | 王晶霞, 汤灵玲. 肠道微生物群疗法防治复发性艰难梭菌感染研究进展[J]. 临床荟萃, 2022, 37(8): 759-763. |
[8] | 贾卓雅, 陈晓依, 陈树春. 胰高糖素样肽-1受体激动剂改善肥胖致雄性生殖功能下降的作用机制[J]. 临床荟萃, 2022, 37(7): 658-662. |
[9] | 杨静静, 黄帅, 吴倩, 赵丽丽, 蒋影. 胰高血糖素样肽-1受体激动剂治疗肥胖的研究进展[J]. 临床荟萃, 2022, 37(5): 477-480. |
[10] | 杜菲, 李英. 老年糖尿病肾病患者肠道菌群失调的研究进展[J]. 临床荟萃, 2022, 37(2): 178-181. |
[11] | 杨燕, 王德峰. 肠道菌群在糖尿病治疗中的研究进展[J]. 临床荟萃, 2022, 37(10): 953-956. |
[12] | 龚琳捷, 张松. 低碳生酮饮食干预2型糖尿病的研究进展[J]. 临床荟萃, 2021, 36(7): 651-654. |
[13] | 李超1,宋文惠2. 肥胖症儿童临床相关因素[J]. 临床荟萃, 2020, 35(2): 177-180. |
[14] | 郭蕊1, 韦祁山2,李雯彬3,朱慧1,于国伟1. 短链脂肪酸通过肠脑轴改善肥胖的研究进展[J]. 临床荟萃, 2019, 34(12): 1148-1152. |
[15] | 邱轩,徐晓蒙,刘宽芝. 关于肥胖,你知道多少?[J]. 临床荟萃, 2017, 32(9): 812-812. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||