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Publications

Journal Article Review Epublish 38 citations

PubMed: 38596222 DOI: 10.3389/fendo.2024.1333778

Gut microbiota and therapy for obesity and type 2 diabetes.

Front Endocrinol (Lausanne) 15:1333778

Authors: Luyao Zhang, Pai Wang, Juan Huang, Yanpeng Xing, F Susan Wong, Jian Suo, Li Wen

Affiliations

  • Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China. Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States.
  • Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States. National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, Changsha, Hunan, China. Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
  • Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom.
  • Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China.
  • Section of Endocrinology, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States.

Abstract

There has been a major increase in Type 2 diabetes and obesity in many countries, and this will lead to a global public health crisis, which not only impacts on the quality of life of individuals well but also places a substantial burden on healthcare systems and economies. Obesity is linked to not only to type 2 diabetes but also cardiovascular diseases, musculoskeletal disorders, and certain cancers, also resulting in increased medical costs and diminished quality of life. A number of studies have linked changes in gut in obesity development. Dysbiosis, a deleterious change in gut microbiota composition, leads to altered intestinal permeability, associated with obesity and Type 2 diabetes. Many factors affect the homeostasis of gut microbiota, including diet, genetics, circadian rhythms, medication, probiotics, and antibiotics. In addition, bariatric surgery induces changes in gut microbiota that contributes to the metabolic benefits observed post-surgery. Current obesity management strategies encompass dietary interventions, exercise, pharmacotherapy, and bariatric surgery, with emerging treatments including microbiota-altering approaches showing promising efficacy. While pharmacotherapy has demonstrated significant advancements in recent years, bariatric surgery remains one of the most effective treatments for sustainable weight loss. However, access to this is generally limited to those living with severe obesity. This underscores the need for non-surgical interventions, particularly for adolescents and mildly obese patients. In this comprehensive review, we assess longitudinal alterations in gut microbiota composition and functionality resulting from the two currently most effective anti-obesity treatments: pharmacotherapy and bariatric surgery. Additionally, we highlight the functions of gut microbiota, focusing on specific bacteria, their metabolites, and strategies for modulating gut microbiota to prevent and treat obesity. This review aims to provide insights into the evolving landscape of obesity management and the potential of microbiota-based approaches in addressing this pressing global health challenge.

MeSH

Diabetes Mellitus, Quality Of Life, Obesity Management, Drug Therapy, Diet, Bariatric Surgery, Obesity, Therapeutics, Gastrointestinal Microbiome, Microbiota, Endocrine System Diseases, Diabetes Mellitus, Type 2

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