炎症-内质网应激-肠道菌群在胰岛素抵抗发病中的作用

胰岛素抵抗(insulin resistance,IR)是肥胖导致的代谢综合征的典型表现,因其作用器官广泛和作用机制复杂成为糖尿病等代谢性疾病治疗中的一大难题。胰岛素抵抗涉及多个代谢器官、多种细胞因子和多条信号转导通路的交互作用,呈现出极其复杂的作用网络。目前认为,炎症、内质网应激和肠道菌群失调是引起胰岛素抵抗的最主要的三大机制。本文将综述胰岛素抵抗的三大病理机制,并探讨三者之间的关联性。     

禁食诱导脂肪因子在肠道菌群所致肥胖中的作用机制

肥胖是严重影响国民生活质量的重大问题,其伴随的各种并发症严重影响了人民的身心健康。众多研究揭示了肠道菌群在肥胖发展过程中起重要作用,而禁食诱导脂肪因子(fasting-induced adipose factor,FIAF)在肠道菌群所致肥胖中发挥着重要的作用,参与了脂代谢、慢性低度炎症和代谢性内毒素血症、AMPK、缺氧等多个代谢途径。然而,目前尚未有研究阐明肠道菌群通过FIAF介导肥胖的完整机制。本文在总结大量前人研究的基础上,就FIAF在肠道菌群所致肥胖的发病机制进行综述,以期为肥胖的预防、治疗提供理论依据。     

运动调节肥胖患者肠道菌群的研究进展

肠道菌群是人体肠道的正常微生物,能合成人体生长发育所必需的多种维生素,并参与碳水化合物和蛋白质的代谢,对人体健康起着重要作用。肠道疾病患者的肠道菌群中厚壁菌门（Firmicutes）细菌的相对丰度较高,拟杆菌门（Bacteroidetes）细菌的相对丰度较低,与健康相关的有益菌群相对丰度也较低。研究发现,运动是改善肥胖患者肠道菌群的有效手段。适宜运动可以增加肠道菌群的数量和丰度,改善Firmicutes/Bacteroidetes的比值,有助于肥胖患者减肥。本文通过梳理国内外相关文献,就运动、肥胖与肠道菌群之间关系的研究进展作一综述,以期为运动促进健康、减少肥胖和其他相关疾病提供新的思路。

     

肥胖孕妇肠道菌群与子代肥胖的相关性

妊娠期肥胖发生率在世界范围内呈上升趋势,成为影响人类健康的公共卫生问题。肥胖母亲肠道菌群失调导致婴儿早期定植菌群异常,而婴儿早期菌群定植情况与其日后生长发育密切相关,容易导致成年后出现肥胖、胰岛素抵抗、代谢综合征等疾病。因此针对肥胖孕妇肠道菌群分析,以及婴儿肠道菌群及生长发育的分析,对于孕妇孕期管理、健康宣教提高国民整体身体素质具有重要意义。     

肠道菌群在炎症性肠病发病中的作用

炎症性肠病（IBD）是一种非特异性肠道炎症性疾病,其病因和发病机制尚不完全明确。肠道菌群作为一个非常复杂的微生态系统,在IBD的患病机制中扮演着非常重要的角色。本研究就肠道微生态系统、肠道菌群与IBD发病的关系以及肠道菌群调控对IBD的作用的最新进展进行综述。     

肠道菌群与肥胖关系的研究进展

西方化的高脂饮食方式造成了越来越多的肥胖人群。高脂饮食在一定程度上可以改变肠道菌群的结构组成和功能,促进宿主对食物营养的吸收,从而增加体重形成肥胖。高脂饮食诱导的肥胖者肠道菌群的改变会导致宿主能量吸收增加,肠道通透性和炎症增加,而有减肥功能的短链脂肪酸合成能力下降。最近研究发现肠道菌群也可以通过影响中枢神经系统,尤其是下丘脑相关基因的表达来控制食欲,从而调控肥胖的形成。本文系统介绍了最近几年高脂饮食诱导肥胖的研究,总结了一些与肥胖形成有密切关系的肠道菌群以及其在肥胖形成中的作用机制,为进一步研究肠道菌群与肥胖之间的调控作用奠定了基础。最后总结了肠道菌群可以作为一个预防和治疗肥胖的有效靶点,可以通过在食物中添加有益菌或者通过菌群移植来治疗肥胖。     

2型糖尿病肠道菌群研究进展

2型糖尿病是一种常见的慢性消耗性疾病,其发病机制十分复杂,流行病学研究表明,肥胖、高热量饮食、体力活动不足及年龄增大是2型糖尿病最主要的环境因素。它是一种以胰岛素抵抗和胰岛素分泌不足为特征的代谢性疾病。肠道菌群作为进入人体的一个重要环境因素,肠道微生物的菌群变化影响宿主能量物质的吸收,调节肠道的分泌功能和非特异性免疫功能,从营养、代谢、疾病等各方面与我们生命活动相关。肠道菌群已成为我们身体的一部分,影响宿主的免疫,在肥胖、糖尿病、代谢综合征等疾病中都具有非常重要的作用。     

孕妇肠道菌群与婴幼儿肠道菌群及肥胖的关系研究进展

女性妊娠过程中,身体的生殖、消化、内分泌等系统会发生一系列变化,孕妇的肠道菌群也会发生相应变化。母亲肠道菌群与子代肠道菌群密切相关,婴幼儿生命早期肠道菌群的来源主要有母亲肠道菌群、母亲阴道菌群和母亲体表菌群,出生以后婴幼儿肠道菌群的定殖主要受喂养方式、生活环境、抗生素暴露等因素的影响。此外,人体肠道菌群功能强大,其可通过调节人体营养物质吸收和外周器官的代谢而成为影响肥胖的一种重要的内环境因素。综述孕妇妊娠期间包括孕早期、孕中期、孕晚期肠道菌群的变化和影响婴幼儿肠道菌群定殖的主要因素,以及对子代肥胖的影响,以期为临床医务人员对预防和控制婴幼儿肥胖提供参考。     

肥胖人群肠道菌群特征分析及机器学习模型

【背景】肠道菌群与人体健康之间的关系吸引了越来越多的关注,成为目前热门的研究热点。【目的】基于美国肠道计划公开数据库,对肥胖和健康人群肠道菌群进行比较分析,解析肥胖人群肠道菌群特征,并基于肠道菌群建立机器学习模型预测人群肥胖的状态,为基于肠道菌群干预肥胖提供理论基础。【方法】从公开数据库中获取美国肠道计划中的肠道菌数据,经过筛选得到1 655个健康(18.530)成年人的肠道菌群数据。针对α多样性,进行了Wilcox秩和检验分析并通过Logsitic回归判定α多样性与肥胖之间的关系;对Unweighted UniFrac、WeightedUniFrac和Bray-Curtis三种β多样性距离进行主成分分析(principalcomponent analysis,PCA),探索肥胖与健康人群在肠道菌群组成上的差异;对于物种差异,进行Wilcox秩和检验探索差异菌属;通过PICRUSt分析预测可能的代谢通路,同时与肠道菌群进行相关性分析。利用Scikit-Learn软件包基于属水平的肠道菌群数据建立肥胖分类机器学习模型,并进行网络搜...     

Feedback models allowing estimation of thresholds for self-promoting body weight gain

Objective: Most people maintain almost constant body weight over long time with varying physical activity and food intake. This indicates the existence of a regulation that works well for most individuals. Yet some people develop obesity, indicating that this regulation sometimes fails. The difference between the two situations is typically an energy imbalance of about 1% over a long period of time.Theory: Weight gain increases basal metabolic rate. Weight gain is often associated with a decrease in physical activity, although not to such an extent that it prevents an increase in total energy expenditure and energy intake. Dependent on the precise balance between these effects of weight gain, they may make the body weight unstable and tend to further promote weight gain. With the aim of identifying the thresholds beyond which such self-promoting weight gain may take place, we develop a simple mathematical model of the body as an energy-consuming machine in which the changes in physical activity and food intake are described as feedback effects in addition to the effect of the weight gain on basal metabolic rate. The feedback parameters of the model may differ between individuals and only in some cases do they take values that make weight gain self-promoting.Results: We determine the quantitative conditions under which body weight gain becomes self-promoting. We find that these conditions can easily be met, and that they are so small that they are not observable with currently available techniques. This phenomenon encourages emphasis on even minor changes in food intake and physical activity to abate or stop weight gain.     

肠道微生物群在介导肠道病原体定植抗性作用的研究进展

肠道微生物群是复杂的微生态系统的组成部分, 参与机体一系列重要的生理过程。健康微生物群在稳态条件下的一个关键功能是抵抗外界病原体的定植, 称为定植抗性。抗生素和质子泵抑制剂的使用, 可引起菌群组成的改变和定植抗性的减弱, 从而为病原体在肠道定植提供了机会, 最终导致感染。细菌性肠道感染是全球疾病的主要原因。肠道微生物群提供定植抗性的机制尚未完全阐明, 但主要分为直接机制和间接机制, 包括抗菌产物的分泌、营养竞争、肠道屏障完整性和免疫反应。本文将从以上几个方面探讨肠道微生物群介导的对肠道病原体的定植抗性。

     

Mouse models for the central melanocortin system

Obesity is characterized by an excess storage of body fat and promotes the risk for complex disease traits such as diabetes mellitus and cardiovascular diseases. The obesity prevalence in Europe is rising and meanwhile ranges from 10 to 20% in men and 15–25% in women. Body fat accumulation occurs in states of positive energy balance and is favored by interactions among environmental, psychosocial and genetic factors. Energy balance is regulated by a complex neuronal network of anorexigenic and orexigenic neurons which integrates peripheral and central hormonal and neuronal signals relaying information on the metabolic status of organs and tissues in the body. A key component of this network is the central melanocortin pathway in the hypothalamus that elicits metabolic and behavioral adaptations for the maintenance of energy homeostasis. Genetic defects in this system cause obesity in mice and humans. In this review we emphasize mouse models with spontaneous natural mutations as well as targeted mutations that contributed to our understanding of the central melanocortin system function in the control of energy balance.     

慢性肾脏病患者胰岛素抵抗的发生情况及其影响因素分析

目的:探究慢性肾脏病(chronic kidney disease,CKD),尤其是非肥胖CKD患者,胰岛素抵抗(insulin resistance,IR)的发生情况,并分析其影响因素。方法:按照纳排标准,选择2016年1月至2017年11月在解放军总医院肾病科就诊的CKD患者共573例,其中非肥胖CKD患者510例,检测患者的身高、体重、空腹胰岛素、血肌酐、血尿素氮等临床指标,计算患者身高体重指数(body mass index,BMI),以BMI≥28 kg/m~2定义为肥胖,按照e GFR水平将CKD分期,建立HOMA指数(HOMA-IR)稳态模型评价IR情况,对CKD患者及非肥胖CKD患者各期IR的发生率进行比较,应用单因素相关性分析和多元逐步回归分析进行HOMA-IR指数相关因素的研究。结果:随着CKD患者肾脏功能的逐渐恶化,IR的发生率逐渐升高。各期CKD患者及非肥胖CKD患者IR的发生率比较差异均具有统计学意义(P=0.019,P=0.000)。在单因素相关性分析结果显示CKD患者的HOMA-IR指数与BMI、血尿素氮、甘油三酯、甲状旁腺激素、CKD分期呈正相关,与总蛋白、白蛋白、高密度脂蛋白、e GFR呈负相关。非肥胖CKD患者的HOMA-IR指数与年龄、尿素氮、甘油三酯、甲状旁腺激素、CKD分期呈正相关,与总蛋白、白蛋白、高密度脂蛋白、e GFR呈负相关。多元回归分析显示CKD患者的BMI、血尿素氮、甘油三酯、CKD分期进入最终回归方程,HOMA-IR与BMI、血尿素氮、甘油三酯、CKD分期呈正相关(P0.05)。非肥胖CKD患者的尿素氮、甲状旁腺激素、CKD分期进入最终回归方程,HOMA-IR与尿素氮、甲状旁腺激素、CKD分期呈正相关(P0.05)。结论:IR的发生率随CKD的进展逐渐升高,肥胖、血尿素氮升高、甘油三酯升高、肾功能降低是CKD患者发生IR的相关危险因素,血尿素氮升高、甲状旁腺激素升高、肾功能降低是非肥胖CKD患者IR发生的相关危险因素。     

Effect of moderate physical activity on plasma leptin concentration in humans

In subjects who maintain a constant body mass, the increased energy expenditure induced by exercise must be compensated by a similar increase in energy intake. Since leptin has been shown to decrease food intake in animals, it can be expected that physical exercise would increase energy intake by lowering plasma leptin concentrations. This effect may be secondary either to exercise-induced negative energy balance or to other effects of exercise. To delineate the effects of moderate physical activity on plasma leptin concentrations, 11 healthy lean subjects (4 men, 7 women) were studied on three occasions over 3 days; in study 1 they consumed an isoenergetic diet (1.3 times resting energy expenditure) over 3 days with no physical activity; in study 2 the subjects received the same diet as in study 1, but they exercised twice daily during the 3 days (cycling at 60 W for 30 min); in study 3 the subjects exercised twice daily during the 3 days, and their energy intake was increased by 18% to cover the extra energy expenditure induced by the physical activity. Fasting plasma leptin concentration (measured on the morning of day 4) was unaltered by exercise [8.64 (SEM 2.22) 7.17 (SEM 1.66), 7.33 (SEM 1.72) 1 microg x l(-1) in studies 1, 2 and 3, respectively]. It was concluded that a moderate physical activity performed over a 3-day period does not alter plasma leptin concentrations, even when energy balance is slightly negative. This argues against a direct effect of physical exercise on plasma leptin concentrations, when body composition is unaltered.     

肥胖者脂肪组织中TNF-α表达与脂肪细胞大小的相关性分析

目的探讨肥胖者网膜脂肪和皮下脂肪两处肿瘤坏死因子-α(TNF-α)蛋白的表达与脂肪细胞大小的相关性。方法选取正常体重者16名,中心型肥胖者32名拟行外科手术患者,术中取出网膜脂肪和皮下脂肪标本,测定脂肪细胞大小,采用western blot方法测定TNF-α蛋白表达。结果肥胖者网膜脂肪和皮下脂肪两处TNF-α蛋白的水平均比正常体重对照组表达高(P<0.01),肥胖者网膜脂肪组织TNF-α蛋白表达高于皮下脂肪(P<0.05),同时研究发现肥胖者皮下脂肪细胞和网膜脂肪细胞大小均明显大于正常体重组(P<0.05),且肥胖者网膜脂肪和皮下脂肪两处脂肪组织TNF-α蛋白表达与脂肪细胞大小呈正相关(网膜:r=0.808,P<0.01;皮下:r=0.452,P<0.05)。结论肥胖者网膜脂肪和皮下脂肪细胞增大,在肥胖相关胰岛素抵抗的发生中起到了重要的作用。     

Dimerization of human recombinant resistin involves covalent and noncovalent interactions

Resistin, an adipocyte secreted cysteine rich hormone has been implicated as molecular link between obesity and type 2 diabetes in a murine model. Although, at the protein level mouse and human resistin show remarkable similarities with respect to conserved cysteine residues, the physiological role of human resistin is not yet clear. In the present study we describe the purification and refolding of human recombinant resistin using two different refolding processes. Gel filtration analysis of protein refolded by both the methods revealed that human recombinant resistin, like mouse resistin, has a tendency to form dimers. Interestingly, dimerization of resistin appears to be mediated by both covalent (disulfide bond mediated) and non-covalent interactions as seen on reducing and non-reducing SDS-PAGE. Circular dichroism spectral analysis revealed that human resistin peptide backbone is a mixture of alpha-helical and beta-sheet conformation with significant amounts of unordered structure, similar to the mouse resistin. It is likely that the first cysteine (Cyst22) of human resistin, which is equivalent to mouse Cyst26, may be involved in stabilizing the dimers through covalent interaction.