medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-23-192-198medsovet-7326Research ArticleЭНДОКРИНОЛОГИЯENDOCRINOLOGYМетаболизм кишечной микробиоты и его роль в течении сахарного диабетаMetabolism of gut microbiota and its role in state of diabetes mellitushttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна - доктор медицинских наук, профессор, заведующая кафедрой эндокринологии лечебного факультета.

117997, Москва, ул. Островитянова, д. 1

Tatiana Yu. Demidova - Dr. Sci. (Med.), Professor, Head of the Department of Endocrinology, Faculty of Medicine, Pirogov Russian National Research Medical University.

1, Ostrovityanov St., Moscow, 117997

t.y.demidova@gmail.comhttps://orcid.org/0000-0002-6826-5924КочинаА. С.KochinaA. S.

Кочина Анна Сергеевна - ассистент кафедры эндокринологии лечебного факультета.

117997, Москва, ул. Островитянова, д. 1

Anna S. Kochina - Assistant of the Department of Endocrinology of the Medical Faculty, Pirogov Russian National Research Medical University.

1, Ostrovityanov St., Moscow, 117997

anna_kochina_@mail.ruhttps://orcid.org/0000-0002-3684-9992КоротковаТ. Н.KorotkovaT. N.

Короткова Татьяна Николаевна – кандидат медицинских наук, заведующая лабораторией клинической биохимии, аллергологии и иммунологии.

109240, Москва, Устьинский проезд, д. 2/14

Tatiana N. Korotkova - Cand. Sci. (Med.), Head of the Laboratory of Clinical Biochemistry, Immunology and Allergology, Federal Research Center of Nutrition, Biotechnology and Food Safety.

2/14, Ustinsky Proezd, Moscow, 109240

tntisha@gmail.comРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationФедеральный исследовательский центр питания, биотехнологии и безопасности пищиРоссияFederal Research Centre of Nutrition, Biotechnology and Food SafetyRussian Federation202220012023023192198Copyright © Демидова Т.Ю., Кочина А.С., Короткова Т.Н., 20232023Демидова Т.Ю., Кочина А.С., Короткова Т.Н.Demidova T.Y., Kochina A.S., Korotkova T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7326

Ежегодно заболеваемость сахарным диабетом (СД) возрастает, число развивающихся осложнений прогрессирует, а большое количество случаев заболевания остается недиагностированным. Все это дает повод говорить о том, что дополнение и усовершенствование современных стратегий лечения заболевания могут изменить нынешнюю обстановку. Известно, что одним из звеньев патогенеза нарушений углеводного обмена, в частности СД, является изменение кишечной микробиоты (КМ) и ее метаболизма. К метаболитам КМ относят короткоцепочечные жирные кислоты (КЦЖК), некоторые газы, энергию и другие низкомолекулярные метаболиты. Наибольший интерес с точки зрения влияния на течение СД представляют КЦЖК. Помимо того что они являются основным источником энергии для колоноцитов, а также проявляют защитные и антиишемические свойства в отношении кишечной стенки, КЦЖК способствуют увеличению насыщения, снижению инсулинорезистентности, обладают протективными свойствами в отношении β-клеток поджелудочной железы и влияют на снижение массы тела. Функции КЦЖК настолько разнообразны, что уместно говорить об их роли в случае СД как с относительной, так и с абсолютной недостаточностью инсулина. Вследствие своей пластичности, КМ может изменять свой состав и функции под воздействием определенных изменений в организме, однако при СД изменения носят стойкий характер, и количество, соотношение и функции микроорганизмов изменяются необратимо, вызывая соответствующие изменения в количества КЦЖК. Учитывая положительное влияние КЦЖК на углеводный обмен, модуляция метаболитов КМ может рассматриваться в качестве эффективного дополнения к терапии СД. Одним из мощных факторов, проявляющих положительное влияние на КМ, являются пищевые волокна (ПВ). ПВ являются субстратом для метаболизма микробиоты, способствуют поддержанию необходимого для КМ pH в просвете кишечника, а также регулируют пассаж пищи в желудочно-кишечном тракте. ПВ и КЦЖК имеют большой потенциал в качестве эффективного дополнения к имеющейся на данный момент противодиабетической терапии.

The number of new cases of diabetes mellitus (DM) and its complications is rapidly increasing and a great amount of cases remains undiagnosed. It demonstrates that improvement of existing methods of treatment can be extremely helpful in present situation. It is known, that one of components of pathogenesis of DM is gut microbiota (GM) and its metabolism. Metabolites of GM include short-chain fatty acids (SCFA), some gases, energy and some low molecular metabolites. From the point of influence on stage of diabetes mellitus SCFA are the most interest. They are not only the main source of energy for colonocytes with antiischemic and protective properties, concerning the gut wall, but they also increase satiety, reduce insulin resistance, improve β-cell function and lead to decrease in body mass. Functions of SCFA are so versatile that they can be mentioned in DM with relative and absolute insulin deficiency as well. Due to its plasticity, GM can change its structure and functions in response to some changes in organism. However, in people with DM these changes are severe and continuous, which makes total amount of microorganisms and their proportion change irreversibly, leading to associated changes in amount of SCFA. Considering the positive effects of SCFA on carbohydrate metabolism, modulation of GM metabolism may occur an efficient addition to antidiabetic therapy. One of the powerful factors, influencing GM, is dietary fiber (DF). They are an energetic substrate for GM, they also maintain pH necessary for GM and regulate food passage in gastrointestinal system. Studying the influence of SCFA on DM and correction of metabolic dysregulation with DF need special attention, as DF and SCFA may become a powerful addition to antidiabetic therapy.

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The authors declare that there are no conflicts of interest present.