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Intestinales Mikrobiom und metabolische Erkrankungen

Von der Adipositas zu Diabetes und nichtalkoholischer Steatohepatitis

The intestinal microbiome and metabolic diseases

From obesity to diabetes and nonalcoholic steatohepatitis

  • Schwerpunkt: Mikrobiom
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Das intestinale Mikrobiom umfasst etwa 10 Mio. Gene, von denen viele Verdauungsenzyme codieren. Dieser Umstand erklärt tier- und humanexperimentelle Befunde, dass das intestinale Mikrobiom sich an die Nahrungsaufnahme anpasst und die Energie- und Substratgewinnung aus der Nahrung optimiert. Diese Funktion kann bei Nahrungsmangel von Vorteil sein, bei Nahrungsüberfluss kann sie Adipositas begünstigen.

Fragestellung

Die Bedeutung des intestinalen Mikrobioms in der Pathogenese der Adipositas und metabolischer Folgeerkrankungen wie Fettlebererkrankung und Diabetes mellitus Typ 2 soll anhand aktueller Literaturdaten dargestellt werden. Mögliche klinische Konsequenzen werden diskutiert.

Material und Methoden

Aktuelle Literatur zum Thema wurde ausgewählt, präsentiert und im Zusammenhang der Fragestellung diskutiert.

Ergebnisse

Das intestinale Mikrobiom spielt eine Rolle in der Pathogenese der Adipositas (durch Steigerung der Energieaufnahme) wie auch in der Pathogenese der Fettlebererkrankung und des Diabetes mellitus Typ 2 (durch Induktion einer subklinischen Entzündung nach Translokation von Lipopolysacchariden aus dem Darm und durch metabolische Dysregulation).

Schlussfolgerung

Diese Ergebnisse könnten zukünftig Bedeutung in der Diagnostik und Therapie von metabolischen Erkrankungen erlangen: diagnostisch in der Identifizierung von Risikosubgruppen, therapeutisch durch den Einsatz bekannter oder neuartiger Probiotika bzw. bakterieller Metaboliten.

Abstract

Background

The intestinal microbiome consists of about 10 million genes, many of which encode digestive enzymes. This explains why animal and human experiments revealed that the intestinal microbiome adapts to food intake and optimizes energy harvest from food. This function is considered beneficial in states of lack of food, but following overnutrition, it might support the development of obesity.

Objectives

The relevance of the intestinal microbiome for the pathogenesis of obesity and associated metabolic diseases such as fatty liver disease and type 2 diabetes mellitus and for the clinical management of such diseases shall be discussed.

Materials and methods

Recent literature related to the topic has been selected, presented, and discussed with regard to the objectives.

Results

The intestinal microbiome plays a role in the pathogenesis of both obesity (by increasing the energy absorption from food) and fatty liver disease as well as type 2 diabetes mellitus (via induction of low-grade inflammation following translocation of lipopolysaccharides from the gut and dysregulation of metabolic pathways).

Conclusions

The findings might have consequences for diagnosis (identification of risk groups) and therapy (usage of known and novel probiotics or bacterial metabolites) of metabolic diseases.

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Authors and Affiliations

  1. Institut für Ernährungsmedizin, Universität Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Deutschland

    S. C. Bischoff

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S.C. Bischoff gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Redaktion

H. Lehnert, Lübeck

J. Mössner, Leipzig

B. Salzberger, Regensburg

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Bischoff, S.C. Intestinales Mikrobiom und metabolische Erkrankungen. Internist 58, 441–448 (2017). https://doi.org/10.1007/s00108-017-0229-9

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  • DOI: https://doi.org/10.1007/s00108-017-0229-9

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