非药物改变肠道微生物群以预防糖尿病肾病的研究进展

Research Progress on Non-Pharmacological Modification of Gut Microbiota for Preventing Diabetic Kidney Disease

摘要: 本综述旨在介绍对糖尿病肾病(diabetic kidney disease, DKD)患者肠道微生物群产生积极影响的干预措施。针对肠道菌群的干预措施(包括益生菌和饮食调整)在调节肠道菌群方面有一定的潜力。饮食调整中部分天然食品如多酚类和花青素可通过调节肠道菌群的组成来帮助清除尿毒症患者体内的毒素，从而延缓糖尿病肾病进展。也有动物模型研究表明粪便微生物移植(FMT)对调节菌群失调及改善慢性肾脏疾病具有积极作用，涉及DKD患者的研究仍显不足，需要进一步研究，未来可能是一个延缓DKD进展的新思路。益生菌中的乳酸杆菌和双歧杆菌可能有助于降低尿素和肌酐水平，尿毒症期患者的研究欠缺。高纤维饮食以及姜黄素等补充剂可通过调节肠道微生物群和减少氧化应激来降低毒素。

Abstract: This review aims to introduce interventions that have positive effects on the gut microbiota in patients with diabetic kidney disease (DKD). Interventions targeting the gut microbiota, including probiotics and dietary adjustments, have shown potential in regulating gut microbiota. Certain natural foods in dietary adjustments, such as polyphenols and anthocyanins, can help remove toxins from the bodies of uremic patients by regulating gut microbiota composition, thereby slowing the progression of DKD. Animal model studies have also shown that fecal microbiota transplantation (FMT) has positive effects on regulating dysbiosis and improving chronic kidney disease, but research involving DKD patients is still insufficient and requires further study. This may be a new approach to slowing DKD progression in the future. Lactobacillus and Bifidobacterium in probiotics may help reduce urea and creatinine levels, but research on uremic patients is lacking. High-fiber diets and supplements such as curcumin can reduce toxins by regulating gut microbiota and reducing oxidative stress.