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减重代谢手术对肠道微生物群的调节及其在NAFLD治疗中的作用
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Abstract:
减重代谢手术已被证实对非酒精性脂肪性肝病(NAFLD)患者具有显著的积极影响，这在很大程度上归功于它对肠道微生物群的调节作用。不同的手术方式对肠道微生物的影响也各不相同，对NAFLD治疗的重点也有所差异。肠道微生物群的失衡是NAFLD发展的重要因素，主要表现为“抗炎”菌群的减少和“促炎”菌群的增加，且NAFLD的病情进展与肠道微生物群的状态密切相关。减重手术通过改变肠道环境，促进有益菌群的增长和潜在有害菌群的减少，从而改善肠道功能，调节胆汁酸的组成和代谢，以及影响食物的消化和吸收。这些变化不仅重塑了肠道内环境，还可能通过肠–肝轴对宿主的生理和代谢状态产生重要影响，进而改善NAFLD的严重程度。
Bariatric metabolic surgery has been proven to significantly benefit patients with nonalcoholic fatty liver disease (NAFLD), primarily due to its regulatory effect on the gut microbiota. Different surgical approaches have varying impacts on the gut microbiota and thus focus on different aspects of NAFLD treatment. The imbalance of the gut microbiota, characterized by a decrease in “anti-inflammatory” bacteria and an increase in “pro-inflammatory” bacteria, is a crucial factor in the development of NAFLD and is inextricably linked to the progression of the disease. Bariatric surgery improves intestinal function by altering the gut environment, promoting the growth of beneficial bacteria, and reducing potentially harmful bacteria. This leads to improved regulation of bile acid composition and metabolism, as well as the digestion and absorption of food. These changes not only reshape the intestinal environment but also significantly affect the host’s physiological and metabolic status through the gut-liver axis, thereby ameliorating the severity of NAFLD.
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