背景:糖尿病是一种慢性且非常复杂的疾病,可导致微血管并发症。最近的证据表明,微生物群组成的菌群失调可能导致低度,当地,全身炎症,这直接有助于糖尿病的发展及其微血管后果。
目的:本系统综述的目的是探讨糖尿病微血管并发症之间的关系。包括视网膜病变,神经病,肾病,和肠道菌群组成。
方法:在PubMed中进行了系统搜索,Scopus,和ISIWebofScience从数据库开始到2023年3月。筛选,数据提取,质量评估由两名独立作者进行.采用纽卡斯尔-渥太华质量评价量表进行质量评价。
结果:从590篇检索到的文章中选出约19篇。在纳入的研究中,肾病比其他糖尿病并发症的研究更多,表明健康微生物群的组成发生了变化,而导致肾损伤的大量尿毒症溶质是由肠道微生物产生的。Phyla,包括梭菌和变形杆菌,在有和没有神经病变的2型糖尿病患者之间,肠道菌群的变化占大多数。在视网膜病变的病例中,观察到致病性和促炎细菌的增加。
结论:我们的结果表明,拟杆菌的增加,蛋白杆菌和融合杆菌可能与糖尿病肾病的发病机制有关,神经病,和视网膜病变。鉴于肠道菌群失调在糖尿病相关并发症发展中的有害作用,肠道微生物群评估可用作未来的生物标志物,调节糖尿病患者微生物群组成的干预措施可用于预防和控制这些并发症。
BACKGROUND: Diabetes is one of the chronic and very complex diseases that can lead to microvascular complications. Recent evidence demonstrates that dysbiosis of the microbiota composition might result in low-grade, local, and systemic inflammation, which contributes directly to the development of diabetes mellitus and its microvascular consequences.
OBJECTIVE: The aim of this systematic
review was to investigate the association between diabetes microvascular complications, including
retinopathy, neuropathy, nephropathy, and gut microbiota composition.
METHODS: A systematic search was carried out in PubMed, Scopus, and ISI Web of Science from database inception to March 2023. Screening, data extraction, and quality assessment were performed by two independent authors. The Newcastle-Ottawa Quality Assessment Scale was used for quality assessment.
RESULTS: About 19 articles were selected from 590 retrieved articles. Among the included studies, nephropathy has been studied more than other complications of diabetes, showing that the composition of the healthy microbiota is changed, and large quantities of uremic solutes that cause kidney injury are produced by gut microbes. Phyla, including Fusobacteria and Proteobacteria, accounted for the majority of the variation in gut microbiota between Type 2 diabetic patients with and without neuropathy. In cases with
retinopathy, an increase in pathogenic and proinflammatory bacteria was observed.
CONCLUSIONS: Our results revealed that increases in Bacteroidetes, Proteobacteria and Fusobacteria may be associated with the pathogenesis of diabetic nephropathy, neuropathy, and
retinopathy. In view of the detrimental role of intestinal dysbiosis in the development of diabetes-related complications, gut microbiota assessment may be used as a biomarker in the future and interventions that modulate the composition of microbiota in individuals with diabetes can be used to prevent and control these complications.