Мікробіом кишечнику і цукровий діабет 2 типу

O.Yе. Gridnyev; K.Yu. Dubrov

doi:10.30978/UTJ2019-4-69

Автор(и)

O.Yе. Gridnyev ДУ «Національний інститут терапії імені Л.Т. Малої НАМН України», Харків, Україна
K.Yu. Dubrov ДУ «Національний інститут терапії імені Л.Т. Малої НАМН України», Харків, Україна

DOI:

https://doi.org/10.30978/UTJ2019-4-69

Ключові слова:

цукровий діабет 2 типу, мікробіом кишечнику, метформін, інсулінорезистентність

Анотація

У статті викладені сучасні уявлення про роль мікробіома кишечнику в патогенетичних механізмах розвитку інсулінорезистентності та цукрового діабету (ЦД) 2 типу. Наведено дані про вплив особливостей харчування і медикаментів на формування кишкового мікробіома, у тому числі різних харчових добавок. Так само показана роль коротколанцюгових жирних кислот згідно з даними досліджень на тваринних моделях і на пацієнтах з ЦД 2 типу в розвитку інсулінорезистентності та порушень метаболізму глюкози. Окремо висвітлені питання участі жовчних кислот у розвитку інсулінорезистентності та ЦД 2 типу. Наведено дані різних досліджень із зазначенням які саме зміни відбуваються в складі мікробіома кишечнику при інсулінорезистентності, предіабеті, ЦД 2 типу на експериментальних тваринних моделях і у людей з даними захворюваннями. Описана роль ендотоксину кишкового мікробіома в розвитку інсулінорезистентності та ЦД 2 типу та результати його застосування на тваринних моделях. Наведено дані про механізми впливу бактеріального ендотоксину, у тому числі через Toll-подібні рецептори, гени мієлоїдного диференціювання і ядерний фактор «каппа-бі» на розвиток запальних процесів. Окремо висвітлені питання змін мікробіома кишечнику при лікуванні метформіном хворих на ЦД 2 типу та їх роль у потенціюванні гіпоглікемічної дії метформіну. Описані зміни кількості бактерій Akkermansia muciniphila у пацієнтів з ЦД 2 типу, що приймають метформін та наведені результати застосування даного виду бактерій на мишах. Наведено можливі шляхи впливу на мікробіом кишечнику з метою нормалізації його стану та окреслено перспективи нових методів.

Біографії авторів

O.Yе. Gridnyev, ДУ «Національний інститут терапії імені Л.Т. Малої НАМН України», Харків

О.Є. Гріднєв

K.Yu. Dubrov, ДУ «Національний інститут терапії імені Л.Т. Малої НАМН України», Харків

К.Ю. Дубров

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