medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-032medsovet-9079Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSИзменение состава кишечной микробиоты у пациентов с предиабетом и сахарным диабетом 2-го типаAlteration of gut microbiota composition in patients with prediabetes and type 2 diabetes mellitushttps://orcid.org/0000-0002-7893-145XМыриноваО. А.MyrinovaO. A.

Мыринова Ольга Александровна, аспирант кафедры эндокринологии 

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Olga A. Myrinova, Postgraduate Student of the Department of Endocrinology

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

myrinova_o_a@staff.sechenov.ruhttps://orcid.org/0000-0001-9403-265XТульскийА. А.TulskyA. A.

Тульский Андрей Алексеевич, аспирант кафедры эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Andrey A. Tulsky, Posgraduate Student of the Department of Endocrinology 

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

andrey.a.tulsky@gmail.comhttps://orcid.org/0000-0001-7658-7053ЩетининаА. О.ShchetininaA. O.

Щетинина Анна Олеговна, к.м.н., ассистент кафедры эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Anna O. Shchetinina, Cand. Sci. (Med.), Assistant of the Department of Endocrinology

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

shchetinina_a_o@staff.sechenov.ruhttps://orcid.org/0000-0002-0202-1257МартиросянН. С.MartirosianN. S.

Мартиросян Нарине Степановна, к.м.н., доцент кафедры эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Narine S. Martirosian, Cand. Sci. (Med.), Associate Professor of the Department of Endocrinology

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

martirosyan_n_s@staff.sechenov.ruhttps://orcid.org/0000-0001-7923-4894КузинаИ. А.KuzinaI. A.

Кузина Ирина Александровна, ассистент кафедры эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

 Irina A. Kuzina, Assistant at the Department of Endocrinology 

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

kuzina_i_a@staff.sechenov.ruhttps://orcid.org/0000-0001-7025-8427ГончароваЕ. В.GoncharovaE. V.

Гончарова Екатерина Валерьевна, к.м.н., доцент кафедры эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Ekaterina V. Goncharova, Cand. Sci. (Med.), Associate Professor of the Department of Endocrinology

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

goncharova_e_v_2@staff.sechenov.ruhttps://orcid.org/0000-0001-8007-9721ТельноваМ. Э.TelnovaM. E.

Тельнова Милена Эдуардовна, к.м.н., доцент кафедры эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Milena E. Telnova, Cand. Sci. (Med.), Associate Professor of the Department of Endocrinology

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

telnova_m_e@staff.sechenov.ruhttps://orcid.org/0009-0004-7026-4471ЭльмурзаеваЭ. А.ElmurzaevaE. A.

Эльмурзаева Эльмира Акрамовна, студент Института клинической медицины имени Н.В. Склифосовского

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Elmira A. Elmurzaeva, Student of the N.V. Sklifosovsky Institute of Clinical Medicine 

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

elmi.rami@yandex.ruhttps://orcid.org/0000-0001-9390-1200ПетунинаН. А.PetuninaN. A.

Петунина Нина Александровна, чл.- корр. РАН, д.м.н., профессор, заведующая кафедрой эндокринологии

119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Nina A. Petunina, Corr. Member RAS, Dr. Sci. (Med.), Professor, Head of the Department of Endocrinology 

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia

petunina_n_a@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202524052025064859Copyright © Мыринова О.А., Тульский А.А., Щетинина А.О., Мартиросян Н.С., Кузина И.А., Гончарова Е.В., Тельнова М.Э., Эльмурзаева Э.А., Петунина Н.А., 20252025Мыринова О.А., Тульский А.А., Щетинина А.О., Мартиросян Н.С., Кузина И.А., Гончарова Е.В., Тельнова М.Э., Эльмурзаева Э.А., Петунина Н.А.Myrinova O.A., Tulsky A.A., Shchetinina A.O., Martirosian N.S., Kuzina I.A., Goncharova E.V., Telnova M.E., Elmurzaeva E.A., Petunina N.A.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/9079

Предиабет является фактором риска развития сахарного диабета 2-го типа (СД2), а также его осложнений. Распространенность предиабета и сахарного диабета резко возросла в последние десятилетия. Известно, что нерациональное питание и малоподвижный образ жизни способствуют возникновению СД2. Однако в последнее время все больше внимания уделяется роли кишечной микробиоты в патогенезе и прогрессировании нарушений углеводного обмена. Микробиота кишечника играет ключевую роль в обмене веществ, иммуномодуляции и общем состоянии здоровья человека, а изменения в составе кишечной микробиоты связаны со многими заболеваниями, включая нарушение уровня глюкозы натощак, нарушение толерантности к глюкозе, повышенную резистентность к инсулину и хроническое вялотекущее воспаление. Цель данного обзора – рассмотреть изменение состава кишечной микробиоты у пациентов с предиабетом и СД2, его влияние на метаболизм. Также в обзоре будет освещена роль таких факторов, как диета и физические упражнения, прием метформина, препаратов группы агонистов рецепторов глюкагоноподобного пептида-1 (арГПП-1), пробиотиков и синбиотиков в изменении состава кишечной микробиоты. Ряд исследований подтверждает, что структурные и функциональные изменения микробиоты кишечника присутствуют не только при СД2, но и при предиабете. Эти данные свидетельствуют о том, что микробиота кишечника может стать мишенью для новых подходов в профилактике развития СД 2 типа. Модуляция микробиоты кишечника с помощью пробиотиков, синбиотиков может иметь положительный эффект при лечении СД2 и связанных с ним осложнений, однако необходимы дальнейшие исследования.

Prediabetes is a risk factor for the development of type 2 diabetes mellitus (T2DM) and its complications. The prediabetes and diabetes mellitus prevalence has increased dramatically in recent decades. It is known that unhealthy diet and sedentary lifestyle promote the T2DM occurrence. However, more and more attention has been paid to the role of gut microbiota in the carbohydrate metabolism disorders pathogenesis and progression recently. The gut microbiota plays a key role in metabolism, immunomodulation and overall human health. Changes in the gut microbiota composition are associated with many diseases, including impaired fasting glucose, impaired glucose tolerance, increased insulin resistance and chronic low-grade inflammation. The review purpose is to consider the gut microbiota composition changes in patients with prediabetes and T2DM and its effect on metabolism. The review will also highlight the role of factors such as diet, exercise, taking metformin, glucagon-like peptide-1 receptor agonists (GLP-1 RA), probiotics, and synbiotics in changing the gut microbiota composition. Several studies confirm that structural and functional changes in the intestinal microbiota are present not only in T2DM, but also in prediabetes. These data suggest that the gut microbiota may be a target for new approaches to prevent the T2DM development. Modulation of gut microbiota with probiotics, synbiotics may have positive effects in the treatment of T2DM and related complications, but more studies are needed.

кишечная микробиотасахарный диабет 2-го типапредиабеткороткоцепочечные жирные кислотыметформинагонисты рецепторов глюкагоноподобного пептида 1пробиотикиgut microbiotatype 2 diabetesprediabetesshort-chain fatty acidsmetforminGlucagon-like peptide-1 receptor agonistsprobioticsReferencesDiener C, Reyes-Escogido ML, Jimenez-Ceja LM, Matus M, Gomez-Navarro CM, Chu ND et al. Progressive Shifts in the Gut Microbiome Reflect Prediabetes and Diabetes Development in a Treatment-Naive Mexican Cohort. Front Endocrinol. 2021;11:602326. https://doi.org/10.3389/fendo.2020.602326.Diener C, Reyes-Escogido ML, Jimenez-Ceja LM, Matus M, Gomez-Navarro CM, Chu ND et al. Progressive Shifts in the Gut Microbiome Reflect Prediabetes and Diabetes Development in a Treatment-Naive Mexican Cohort. Front Endocrinol. 2021;11:602326. https://doi.org/10.3389/fendo.2020.602326.Iatcu CO, Steen A, Covasa M. Gut Microbiota and Complications of Type-2 Diabetes. Nutrients. 2021;14(1):166. https://doi.org/10.3390/nu14010166.Iatcu CO, Steen A, Covasa M. Gut Microbiota and Complications of Type-2 Diabetes. Nutrients. 2021;14(1):166. https://doi.org/10.3390/nu14010166.Wu H, Tremaroli V, Schmidt C, Lundqvist A, Olsson LM, Krämer M et al. The Gut Microbiota in Prediabetes and Diabetes: A Population-Based Cross-Sectional Study. Cell Metab. 2020;32(3):379–390.e3. https://doi.org/10.1016/j.cmet.2020.06.011.Wu H, Tremaroli V, Schmidt C, Lundqvist A, Olsson LM, Krämer M et al. The Gut Microbiota in Prediabetes and Diabetes: A Population-Based CrossSectional Study. Cell Metab. 2020;32(3):379–390.e3. https://doi.org/10.1016/j.cmet.2020.06.011.Moffa S, Mezza T, Cefalo CMA, Cinti F, Impronta F, Sorice GP et al. The Interplay between Immune System and Microbiota in Diabetes. Mediators Inflamm. 2019;2019:9367404. https://doi.org/10.1155/2019/9367404.Moffa S, Mezza T, Cefalo CMA, Cinti F, Impronta F, Sorice GP et al. The Interplay between Immune System and Microbiota in Diabetes. Mediators Inflamm. 2019;2019:9367404. https://doi.org/10.1155/2019/9367404.Rinninella E, Raoul P, Cintoni M, Franceschi F, Miggiano GAD, Gasbarrini A, Mele MC. What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms. 2019;7(1):14. https://doi.org/10.3390/microorganisms7010014.Rinninella E, Raoul P, Cintoni M, Franceschi F, Miggiano GAD, Gasbarrini A, Mele MC. What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms. 2019;7(1):14. https://doi.org/10.3390/microorganisms7010014.Zhang D, Jian YP, Zhang YN, Li Y, Gu LT, Sun HH et al. Short-chain fatty acids in diseases. Cell Commun Signal. 2023;21(1):212. https://doi.org/10.1186/s12964-023-01219-9.Zhang D, Jian YP, Zhang YN, Li Y, Gu LT, Sun HH et al. Short-chain fatty acids in diseases. Cell Commun Signal. 2023;21(1):212. https://doi.org/10.1186/s12964-023-01219-9.Masse KE, Lu VB. Short-chain fatty acids, secondary bile acids and indoles: gut microbial metabolites with effects on enteroendocrine cell function and their potential as therapies for metabolic disease. Front Endocrinol. 2023;25;14:1169624. https://doi.org/10.3389/fendo.2023.1169624.Masse KE, Lu VB. Short-chain fatty acids, secondary bile acids and indoles: gut microbial metabolites with effects on enteroendocrine cell function and their potential as therapies for metabolic disease. Front Endocrinol. 2023;25;14:1169624. https://doi.org/10.3389/fendo.2023.1169624.Koh A, De Vadder F, Kovatcheva-Datchary P, Bäckhed F. From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites. Cell. 2016;165(6):1332–1345. https://doi.org/10.1016/j.cell.2016.05.041.Koh A, De Vadder F, Kovatcheva-Datchary P, Bäckhed F. From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites. Cell. 2016;165(6):1332–1345. https://doi.org/10.1016/j.cell.2016.05.041.Parada Venegas D, De la Fuente MK, Landskron G, González MJ, Quera R, Dijkstra G et al. Short Chain Fatty Acids (SCFAs)-Mediated Gut Epithelial and Immune Regulation and Its Relevance for Inflammatory Bowel Diseases. Front Immunol. 2019;10:277. https://doi.org/10.3389/fimmu.2019.00277.Parada Venegas D, De la Fuente MK, Landskron G, González MJ, Quera R, Dijkstra G et al. Short Chain Fatty Acids (SCFAs)-Mediated Gut Epithelial and Immune Regulation and Its Relevance for Inflammatory Bowel Diseases. Front Immunol. 2019;10:277. https://doi.org/10.3389/fimmu.2019.00277.Morrison DJ, Preston T. Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism. Gut Microbes. 2016;7(3):189–200. https://doi.org/10.1080/19490976.2015.1134082.Morrison DJ, Preston T. Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism. Gut Microbes. 2016;7(3):189–200. https://doi.org/10.1080/19490976.2015.1134082.Forslund K, Hildebrand F, Nielsen T, Falony G, Le Chatelier E, Sunagawa S et al. Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota. Nature. 2015;528(7581):262–266. https://doi.org/10.1038/nature15766.Forslund K, Hildebrand F, Nielsen T, Falony G, Le Chatelier E, Sunagawa S et al. Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota. Nature. 2015;528(7581):262–266. https://doi.org/10.1038/nature15766.Chambers ES, Viardot A, Psichas A, Morrison DJ, Murphy KG, Zac-Varghese SE et al. Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults. Gut. 2015;64(11):1744–1754. https://doi.org/10.1136/gutjnl-2014-307913.Chambers ES, Viardot A, Psichas A, Morrison DJ, Murphy KG, Zac-Varghese SE et al. Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults. Gut. 2015;64(11):1744–1754. https://doi.org/10.1136/gutjnl-2014-307913.Tolhurst G, Heffron H, Lam YS, Parker HE, Habib AM, Diakogiannaki E et al. Short-chain fatty acids stimulate glucagon-like peptide-1 secretion via the G-protein-coupled receptor FFAR2. Diabetes. 2012;61(2):364–371. https://doi.org/10.2337/db11-1019.Tolhurst G, Heffron H, Lam YS, Parker HE, Habib AM, Diakogiannaki E et al. Short-chain fatty acids stimulate glucagon-like peptide-1 secretion via the G-protein-coupled receptor FFAR2. Diabetes. 2012;61(2):364–371. https://doi.org/10.2337/db11-1019.Zeng Y, Wu Y, Zhang Q, Xiao X. Crosstalk between glucagon-like peptide 1 and gut microbiota in metabolic diseases. mBio. 2024;15(1):e0203223. https://doi.org/10.1128/mbio.02032-23.Zeng Y, Wu Y, Zhang Q, Xiao X. Crosstalk between glucagon-like peptide 1 and gut microbiota in metabolic diseases. mBio. 2024;15(1):e0203223. https://doi.org/10.1128/mbio.02032-23.Zhang X, Shen D, Fang Z, Jie Z, Qiu X, Zhang C et al. Human gut microbiota changes reveal the progression of glucose intolerance. PLoS ONE. 2013;8(8):e71108. https://doi.org/10.1371/journal.pone.0071108.Zhang X, Shen D, Fang Z, Jie Z, Qiu X, Zhang C et al. Human gut microbiota changes reveal the progression of glucose intolerance. PLoS ONE. 2013;8(8):e71108. https://doi.org/10.1371/journal.pone.0071108.Zhang Z, Tian T, Chen Z, Liu L, Luo T, Dai J. Characteristics of the gut microbiome in patients with prediabetes and type 2 diabetes. Peer J. 2021;24;9:e10952. https://doi.org/10.7717/peerj.10952.Zhang Z, Tian T, Chen Z, Liu L, Luo T, Dai J. Characteristics of the gut microbiome in patients with prediabetes and type 2 diabetes. Peer J. 2021;24;9:e10952. https://doi.org/10.7717/peerj.10952.Egshatyan L, Kashtanova D, Popenko A, Tkacheva O, Tyakht A, Alexeev D et al. Gut microbiota and diet in patients with different glucose tolerance. Endocr Connect. 2016;5(1):1–9. https://doi.org/10.1530/EC-15-0094.Egshatyan L, Kashtanova D, Popenko A, Tkacheva O, Tyakht A, Alexeev D et al. Gut microbiota and diet in patients with different glucose tolerance. Endocr Connect. 2016;5(1):1–9. https://doi.org/10.1530/EC-15-0094.Belzer C, de Vos WM. Microbes inside – from diversity to function: the case of Akkermansia. ISME J. 2012;6(8):1449–1458. https://doi.org/10.1038/ismej.2012.6.Belzer C, de Vos WM. Microbes inside – from diversity to function: the case of Akkermansia. ISME J. 2012;6(8):1449–1458. https://doi.org/10.1038/ismej.2012.6.Diener C, Reyes-Escogido ML, Jimenez-Ceja LM, Matus M, Gomez-Navarro CM, Chu ND et al. Progressive Shifts in the Gut Microbiome Reflect Prediabetes and Diabetes Development in a Treatment-Naive Mexican Cohort. Front Endocrinol. 2021;11:602326. https://doi.org/10.3389/fendo.2020.602326.Diener C, Reyes-Escogido ML, Jimenez-Ceja LM, Matus M, Gomez-Navarro CM, Chu ND et al. Progressive Shifts in the Gut Microbiome Reflect Prediabetes and Diabetes Development in a Treatment-Naive Mexican Cohort. Front Endocrinol. 2021;11:602326. https://doi.org/10.3389/fendo.2020.602326.Allin KH, Tremaroli V, Caesar R, Jensen BAH, Damgaard MTF, Bahl MI et al. Aberrant intestinal microbiota in individuals with prediabetes. Diabetologia. 2018;61(4):810–820. https://doi.org/10.1007/s00125-018-4550-1.Allin KH, Tremaroli V, Caesar R, Jensen BAH, Damgaard MTF, Bahl MI et al. Aberrant intestinal microbiota in individuals with prediabetes. Diabetologia. 2018;61(4):810–820. https://doi.org/10.1007/s00125-018-4550-1.Wang L, Yu X, Xu X, Ming J, Wang Z, Gao B et al. The Fecal Microbiota Is Already Altered in Normoglycemic Individuals Who Go on to Have Type 2 Diabetes. Front Cell Infect Microbiol. 2021;11:598672. https://doi.org/10.3389/fcimb.2021.598672.Wang L, Yu X, Xu X, Ming J, Wang Z, Gao B et al. The Fecal Microbiota Is Already Altered in Normoglycemic Individuals Who Go on to Have Type 2 Diabetes. Front Cell Infect Microbiol. 2021;11:598672. https://doi.org/10.3389/fcimb.2021.598672.Wu H, Esteve E, Tremaroli V, Khan MT, Caesar R, Mannerås-Holm L et al. Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug. Nat Med. 2017;23(7):850–858. https://doi.org/10.1038/nm.4345.Wu H, Esteve E, Tremaroli V, Khan MT, Caesar R, Mannerås-Holm L et al. Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug. Nat Med. 2017;23(7):850–858. https://doi.org/10.1038/nm.4345.De la Cuesta-Zuluaga J, Mueller NT, Corrales-Agudelo V, Velásquez-Mejía EP, Carmona JA, Abad JM, Escobar JS. Metformin Is Associated With Higher Relative Abundance of Mucin-Degrading Akkermansia muciniphila and Several Short-Chain Fatty Acid-Producing Microbiota in the Gut. Diabetes Care. 2017;40(1):54–62. https://doi.org/10.2337/dc16-1324.De la Cuesta-Zuluaga J, Mueller NT, Corrales-Agudelo V, Velásquez-Mejía EP, Carmona JA, Abad JM, Escobar JS. Metformin Is Associated With Higher Relative Abundance of Mucin-Degrading Akkermansia muciniphila and Several Short-Chain Fatty Acid-Producing Microbiota in the Gut. Diabetes Care. 2017;40(1):54–62. https://doi.org/10.2337/dc16-1324.Wang Z, Saha S, Van Horn S, Thomas E, Traini C, Sathe G et al. Gut microbiome differences between metformin- and liraglutide-treated T2DM subjects. Endocrinol Diabetes Metab. 2017;1(1):e00009. https://doi.org/10.1002/edm2.9.Wang Z, Saha S, Van Horn S, Thomas E, Traini C, Sathe G et al. Gut microbiome differences between metformin- and liraglutide-treated T2DM subjects. Endocrinol Diabetes Metab. 2017;1(1):e00009. https://doi.org/10.1002/edm2.9.Ying X, Rongjiong Z, Kahaer M, Chunhui J, Wulasihan M. Therapeutic efficacy of liraglutide versus metformin in modulating the gut microbiota for treating type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease. Front Microbiol. 2023;14:1088187. https://doi.org/10.3389/fmicb.2023.1088187.Ying X, Rongjiong Z, Kahaer M, Chunhui J, Wulasihan M. Therapeutic efficacy of liraglutide versus metformin in modulating the gut microbiota for treating type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease. Front Microbiol. 2023;14:1088187. https://doi.org/10.3389/fmicb.2023.1088187.Tsai CY, Lu HC, Chou YH, Liu PY, Chen HY, Huang MC et al. Gut Microbial Signatures for Glycemic Responses of GLP-1 Receptor Agonists in Type 2 Diabetic Patients: A Pilot Study. Front Endocrinol. 2022;12:814770. https://doi.org/10.3389/fendo.2021.814770.Tsai CY, Lu HC, Chou YH, Liu PY, Chen HY, Huang MC et al. Gut Microbial Signatures for Glycemic Responses of GLP-1 Receptor Agonists in Type 2 Diabetic Patients: A Pilot Study. Front Endocrinol. 2022;12:814770. https://doi.org/10.3389/fendo.2021.814770.Capehorn MS, Catarig AM, Furberg JK, Janez A, Price HC, Tadayon S et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab. 2020;46(2):100–109. https://doi.org/10.1016/j.diabet.2019.101117.Capehorn MS, Catarig AM, Furberg JK, Janez A, Price HC, Tadayon S et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab. 2020;46(2):100–109. https://doi.org/10.1016/j.diabet.2019.101117.Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. https://doi.org/10.1001/jama.2021.23619.Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138–150. https://doi.org/10.1001/jama.2021.23619.Аметов АС, Шохин ИЕ, Рогожина ЕА, Бодрова ТГ, Невретдинова МЕ, Белый ПА и др. Сравнительный анализ физико-химических свойств, биоэквивалентности, безопасности и переносимости отечественного семаглутида. Фармация и фармакология. 2023;11(4):324–346. https://doi.org/10.19163/2307-9266-2023-11-4-324-346.Ametov AS, Shokhin IE, Rogozhina EA, Bodrova TG, Nevretdinova ME, Bely PA et al. Comparative analysis of physicochemical properties, bioequivalence, safety and tolerability of the first domestic semaglutide. Farmatsiya i Farmakologiya. 2023;11(4):324–346. (In Russ.) https://doi.org/10.19163/2307-9266-2023-11-4-324-346.Аметов АС, Шохин ИЕ, Рогожина ЕА, Бодрова ТГ, Невретдинова МЕ, Белый ПА и др. Российская разработка для лекарственной независимости в эндокринологии: сравнительный анализ биоэквивалентности, безопасности и переносимости первого отечественного лираглутида. Фармация и фармакология. 2023;11(3):255–276. https://doi.org/10.19163/2307-9266-2023-11-3-255-276.Ametov AS, Shokhin IE, Rogozhina EA, Bodrova TG, Nevretdinova ME, Bely PA et al. Russian development for drug independence in endocrinology: comparative analysis of bioequivalence, safety and tolerability of the first domestic liraglutide. Farmatsiya i Farmakologiya. 2023;11(3):255–276. (In Russ.) https://doi.org/10.19163/2307-9266-2023-11-3-255-276.García-Montero C, Fraile-Martínez O, Gómez-Lahoz AM, Pekarek L, Castellanos AJ, Noguerales-Fraguas F et al. Nutritional Components in Western Diet Versus Mediterranean Diet at the Gut Microbiota-Immune System Interplay. Implications for Health and Disease. Nutrients. 2021;13(2):699. https://doi.org/10.3390/nu13020699.García-Montero C, Fraile-Martínez O, Gómez-Lahoz AM, Pekarek L, Castellanos AJ, Noguerales-Fraguas F et al. Nutritional Components in Western Diet Versus Mediterranean Diet at the Gut Microbiota-Immune System Interplay. Implications for Health and Disease. Nutrients. 2021;13(2):699. https://doi.org/10.3390/nu13020699.Campaniello D, Corbo MR, Sinigaglia M, Speranza B, Racioppo A, Altieri C, Bevilacqua A. How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives. Nutrients. 2022;14(12):2456. https://doi.org/10.3390/nu14122456.Campaniello D, Corbo MR, Sinigaglia M, Speranza B, Racioppo A, Altieri C, Bevilacqua A. How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives. Nutrients. 2022;14(12):2456. https://doi.org/10.3390/nu14122456.Fava F, Gitau R, Griffin BA, Gibson GR, Tuohy KM, Lovegrove JA. The type and quantity of dietary fat and carbohydrate alter faecal microbiome and short-chain fatty acid excretion in a metabolic syndrome ‘at-risk’ population. Int J Obes. 2013;37(2):216–223. https://doi.org/10.1038/ijo.2012.33.Fava F, Gitau R, Griffin BA, Gibson GR, Tuohy KM, Lovegrove JA. The type and quantity of dietary fat and carbohydrate alter faecal microbiome and short-chain fatty acid excretion in a metabolic syndrome ‘at-risk’ population. Int J Obes. 2013;37(2):216–223. https://doi.org/10.1038/ijo.2012.33.Beam A, Clinger E, Hao L. Effect of Diet and Dietary Components on the Composition of the Gut Microbiota. Nutrients. 2021;13(8):2795. https://doi.org/10.3390/nu13082795.Beam A, Clinger E, Hao L. Effect of Diet and Dietary Components on the Composition of the Gut Microbiota. Nutrients. 2021;13(8):2795. https://doi.org/10.3390/nu13082795.Pendyala S, Walker JM, Holt PR. A high-fat diet is associated with endotoxemia that originates from the gut. Gastroenterology. 2012;142(5):1100–1101.e2. https://doi.org/10.1053/j.gastro.2012.01.034.Pendyala S, Walker JM, Holt PR. A high-fat diet is associated with endotoxemia that originates from the gut. Gastroenterology. 2012;142(5):1100–1101.e2. https://doi.org/10.1053/j.gastro.2012.01.034.O’Keefe SJD. Plant-based foods and the microbiome in the preservation of health and prevention of disease. Am J Clin Nutr. 2019;110(2):265–266. https://doi.org/10.1093/ajcn/nqz127.O’Keefe SJD. Plant-based foods and the microbiome in the preservation of health and prevention of disease. Am J Clin Nutr. 2019;110(2):265–266. https://doi.org/10.1093/ajcn/nqz127.Tosti V, Bertozzi B, Fontana L. Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. J Gerontol A Biol Sci Med Sci. 2018;73(3):318–326. https://doi.org/10.1093/gerona/glx227.Tosti V, Bertozzi B, Fontana L. Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. J Gerontol A Biol Sci Med Sci. 2018;73(3):318–326. https://doi.org/10.1093/gerona/glx227.Wilson AS, Koller KR, Ramaboli MC, Nesengani LT, Ocvirk S, Chen C et al. Diet and the Human Gut Microbiome: An International Review. Dig Dis Sci. 2020;65(3):723–740. https://doi.org/10.1007/s10620-020-06112-w.Wilson AS, Koller KR, Ramaboli MC, Nesengani LT, Ocvirk S, Chen C et al. Diet and the Human Gut Microbiome: An International Review. Dig Dis Sci. 2020;65(3):723–740. https://doi.org/10.1007/s10620-020-06112-w.Garcia-Mantrana I, Selma-Royo M, Alcantara C, Collado MC. Shifts on Gut Microbiota Associated to Mediterranean Diet Adherence and Specific Dietary Intakes on General Adult Population. Front Microbiol. 2018;9:890. https://doi.org/10.3389/fmicb.2018.00890.Garcia-Mantrana I, Selma-Royo M, Alcantara C, Collado MC. Shifts on Gut Microbiota Associated to Mediterranean Diet Adherence and Specific Dietary Intakes on General Adult Population. Front Microbiol. 2018;9:890. https://doi.org/10.3389/fmicb.2018.00890.Goodrich JK, Waters JL, Poole AC, Sutter JL, Koren O, Blekhman R et al. Human genetics shape the gut microbiome. Cell. 2014;159(4):789–799. https://doi.org/10.1016/j.cell.2014.09.053.Goodrich JK, Waters JL, Poole AC, Sutter JL, Koren O, Blekhman R et al. Human genetics shape the gut microbiome. Cell. 2014;159(4):789–799. https://doi.org/10.1016/j.cell.2014.09.053.Papa E, Docktor M, Smillie C, Weber S, Preheim SP, Gevers D et al. Noninvasive mapping of the gastrointestinal microbiota identifies children with inflammatory bowel disease. PLoS ONE. 2012;7(6):e39242. https://doi.org/10.1371/journal.pone.0039242.Papa E, Docktor M, Smillie C, Weber S, Preheim SP, Gevers D et al. Noninvasive mapping of the gastrointestinal microbiota identifies children with inflammatory bowel disease. PLoS ONE. 2012;7(6):e39242. https://doi.org/10.1371/journal.pone.0039242.Mitsou EK, Kakali A, Antonopoulou S, Mountzouris KC, Yannakoulia M, Panagiotakos DB, Kyriacou A. Adherence to the Mediterranean diet is associated with the gut microbiota pattern and gastrointestinal characteristics in an adult population. Br J Nutr. 2017;117(12):1645–1655. https://doi.org/10.1017/S0007114517001593.Mitsou EK, Kakali A, Antonopoulou S, Mountzouris KC, Yannakoulia M, Panagiotakos DB, Kyriacou A. Adherence to the Mediterranean diet is associated with the gut microbiota pattern and gastrointestinal characteristics in an adult population. Br J Nutr. 2017;117(12):1645–1655. https://doi.org/10.1017/S0007114517001593.De Filippis F, Pellegrini N, Vannini L, Jeffery IB, La Storia A, Laghi L et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut. 2016;65(11):1812–1821. https://doi.org/10.1136/gutjnl-2015-309957.De Filippis F, Pellegrini N, Vannini L, Jeffery IB, La Storia A, Laghi L et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut. 2016;65(11):1812–1821. https://doi.org/10.1136/gutjnl-2015-309957.Lombardo M, Aulisa G, Marcon D, Rizzo G, Tarsisano MG, Di Renzo L et al. Association of Urinary and Plasma Levels of Trimethylamine N-Oxide (TMAO) with Foods. Nutrients. 2021;13(5):1426. https://doi.org/10.3390/nu13051426.Lombardo M, Aulisa G, Marcon D, Rizzo G, Tarsisano MG, Di Renzo L et al. Association of Urinary and Plasma Levels of Trimethylamine N-Oxide (TMAO) with Foods. Nutrients. 2021;13(5):1426. https://doi.org/10.3390/nu13051426.Campaniello D, Corbo MR, Sinigaglia M, Speranza B, Racioppo A, Altieri C, Bevilacqua A. How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives. Nutrients. 2022;14(12):2456. https://doi.org/10.3390/nu14122456.Campaniello D, Corbo MR, Sinigaglia M, Speranza B, Racioppo A, Altieri C, Bevilacqua A. How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives. Nutrients. 2022;14(12):2456. https://doi.org/10.3390/nu14122456.Estaki M, Pither J, Baumeister P, Little JP, Gill SK, Ghosh S et al. Cardiorespiratory fitness as a predictor of intestinal microbial diversity and distinct metagenomic functions. Microbiome. 2016;4(1):42. https://doi.org/10.1186/s40168-016-0189-7.Estaki M, Pither J, Baumeister P, Little JP, Gill SK, Ghosh S et al. Cardiorespiratory fitness as a predictor of intestinal microbial diversity and distinct metagenomic functions. Microbiome. 2016;4(1):42. https://doi.org/10.1186/s40168-016-0189-7.Liu Y, Wang Y, Ni Y, Cheung CKY, Lam KSL, Wang Y et al. Gut Microbiome Fermentation Determines the Efficacy of Exercise for Diabetes Prevention. Cell Metab. 2020;31(1):77–91.e5. https://doi.org/10.1016/j.cmet.2019.11.001.Liu Y, Wang Y, Ni Y, Cheung CKY, Lam KSL, Wang Y et al. Gut Microbiome Fermentation Determines the Efficacy of Exercise for Diabetes Prevention. Cell Metab. 2020;31(1):77–91.e5. https://doi.org/10.1016/j.cmet.2019.11.001.Motiani KK, Collado MC, Eskelinen JJ, Virtanen KA, Löyttyniemi E, Salminen S et al. Exercise Training Modulates Gut Microbiota Profile and Improves Endotoxemia. Med Sci Sports Exerc. 2020;52(1):94–104. https://doi.org/10.1249/MSS.0000000000002112.Motiani KK, Collado MC, Eskelinen JJ, Virtanen KA, Löyttyniemi E, Salminen S et al. Exercise Training Modulates Gut Microbiota Profile and Improves Endotoxemia. Med Sci Sports Exerc. 2020;52(1):94–104. https://doi.org/10.1249/MSS.0000000000002112.Allen JM, Mailing LJ, Niemiro GM, Moore R, Cook MD, White BA et al. Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans. Med Sci Sports Exerc. 2018;50(4):747–757. https://doi.org/10.1249/MSS.0000000000001495.Allen JM, Mailing LJ, Niemiro GM, Moore R, Cook MD, White BA et al. Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans. Med Sci Sports Exerc. 2018;50(4):747–757. https://doi.org/10.1249/MSS.0000000000001495.Bressa C, Bailén-Andrino M, Pérez-Santiago J, González-Soltero R, Pérez M, Montalvo-Lominchar MG et al. Differences in gut microbiota profile between women with active lifestyle and sedentary women. PLoS ONE. 2017;12(2):e0171352. https://doi.org/10.1371/journal.pone.0171352.Bressa C, Bailén-Andrino M, Pérez-Santiago J, González-Soltero R, Pérez M, Montalvo-Lominchar MG et al. Differences in gut microbiota profile between women with active lifestyle and sedentary women. PLoS ONE. 2017;12(2):e0171352. https://doi.org/10.1371/journal.pone.0171352.Ejtahed HS, Mohtadi-Nia J, Homayouni-Rad A, Niafar M, Asghari-Jafarabadi M, Mofid V. Probiotic yogurt improves antioxidant status in type 2 diabetic patients. Nutrition. 2012;28(5):539–543. https://doi.org/10.1016/j.nut.2011.08.013.Ejtahed HS, Mohtadi-Nia J, Homayouni-Rad A, Niafar M, Asghari-Jafarabadi M, Mofid V. Probiotic yogurt improves antioxidant status in type 2 diabetic patients. Nutrition. 2012;28(5):539–543. https://doi.org/10.1016/j.nut.2011.08.013.Soltani S, Ashoori M, Dehghani F, Meshkini F, Clayton ZS, Abdollahi S. Effects of probiotic/synbiotic supplementation on body weight in patients with diabetes: a systematic review and meta-analyses of randomizedcontrolled trials. BMC Endocr Disord. 2023;23(1):86. https://doi.org/10.1186/s12902-023-01338-x.Soltani S, Ashoori M, Dehghani F, Meshkini F, Clayton ZS, Abdollahi S. Effects of probiotic/synbiotic supplementation on body weight in patients with diabetes: a systematic review and meta-analyses of randomizedcontrolled trials. BMC Endocr Disord. 2023;23(1):86. https://doi.org/10.1186/s12902-023-01338-x.Kassaian N, Feizi A, Aminorroaya A, Jafari P, Ebrahimi MT, Amini M. The effects of probiotics and synbiotic supplementation on glucose and insulin metabolism in adults with prediabetes: a double-blind randomized clinical trial. Acta Diabetol. 2018;55(10):1019–1028. https://doi.org/10.1007/s00592-018-1175-2.Kassaian N, Feizi A, Aminorroaya A, Jafari P, Ebrahimi MT, Amini M. The effects of probiotics and synbiotic supplementation on glucose and insulin metabolism in adults with prediabetes: a double-blind randomized clinical trial. Acta Diabetol. 2018;55(10):1019–1028. https://doi.org/10.1007/s00592-018-1175-2.Palacios T, Vitetta L, Coulson S, Madigan CD, Lam YY, Manuel R et al. Targeting the Intestinal Microbiota to Prevent Type 2 Diabetes and Enhance the Effect of Metformin on Glycaemia: A Randomised Controlled Pilot Study. Nutrients. 2020;12(7):2041. https://doi.org/10.3390/nu12072041.Palacios T, Vitetta L, Coulson S, Madigan CD, Lam YY, Manuel R et al. Targeting the Intestinal Microbiota to Prevent Type 2 Diabetes and Enhance the Effect of Metformin on Glycaemia: A Randomised Controlled Pilot Study. Nutrients. 2020;12(7):2041. https://doi.org/10.3390/nu12072041.Oh MR, Jang HY, Lee SY, Jung SJ, Chae SW, Lee SO, Park BH. Lactobacillus plantarum HAC01 Supplementation Improves Glycemic Control in Prediabetic Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021;13(7):2337. https://doi.org/10.3390/nu13072337.Oh MR, Jang HY, Lee SY, Jung SJ, Chae SW, Lee SO, Park BH. Lactobacillus plantarum HAC01 Supplementation Improves Glycemic Control in Prediabetic Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021;13(7):2337. https://doi.org/10.3390/nu13072337.Paul P, Kaul R, Harfouche M, Arabi M, Al-Najjar Y, Sarkar A et al. The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials. Pharmacol Res. 2022;185:106520. https://doi.org/10.1016/j.phrs.2022.106520.Paul P, Kaul R, Harfouche M, Arabi M, Al-Najjar Y, Sarkar A et al. The effect of microbiome-modulating probiotics, prebiotics and synbiotics on glucose homeostasis in type 2 diabetes: A systematic review, meta-analysis, and meta-regression of clinical trials. Pharmacol Res. 2022;185:106520. https://doi.org/10.1016/j.phrs.2022.106520.Soltani S, Ashoori M, Dehghani F, Meshkini F, Clayton ZS, Abdollahi S. Effects of probiotic/synbiotic supplementation on body weight in patients with diabetes: a systematic review and meta-analyses of randomizedcontrolled trials. BMC Endocr Disord. 2023;23(1):86. https://doi.org/10.1186/s12902-023-01338-x.Soltani S, Ashoori M, Dehghani F, Meshkini F, Clayton ZS, Abdollahi S. Effects of probiotic/synbiotic supplementation on body weight in patients with diabetes: a systematic review and meta-analyses of randomizedcontrolled trials. BMC Endocr Disord. 2023;23(1):86. https://doi.org/10.1186/s12902-023-01338-x.Тульский АА, Мыринова ОА, Щетинина АО, Мартиросян НС, Гончарова ЕВ, Кузина ИА и др. Ассоциация между кишечной микробиотой и дисфункцией щитовидной железы. Медицинский совет. 2024;(6):240–249. https://doi.org/10.21518/ms2024-073.Tulsky AA, Myrinova OA, Shchetinina AO, Martirosian NS, Goncharova EV, Kuzina IA et al. Association between gut microbiota and thyroid dysfunction. Meditsinskiy Sovet. 2024;(6):240–249. (In Russ.) https://doi.org/10.21518/ms2024-073.

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