Изменение состава кишечной микробиоты у пациентов с предиабетом и сахарным диабетом 2-го типа

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.

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