仝小林+赵立平等:中药复方富集有益肠道菌,改善2型糖尿病合并高血脂症

2型糖尿病合并高血脂症患者随机分入二甲双胍或中药复方(AMC,含8味中药)组,治疗12周后每组随机选取100例进行评估;
两种药物均显著缓解了患者的高血糖和高血脂,改变了肠道菌群,以Blautia菌属细菌为代表的共富集菌的增加与糖脂稳态的改善显著相关;
AMC对肠道菌群影响更大,改善HOMA-IR和血浆甘油三酯效果更好,与以栖粪杆菌属细菌为代表的共富集菌的增多相关;
两种药物可能通过富集Blautia和栖粪杆菌等有益菌功能群来改善疾病。
延伸阅读
mBio [IF:6.689]

Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial

二甲双胍和中药复方改善患者2型糖尿病合并高脂血症期间的肠道菌群结构变化:一项多中心、随机、开放临床试验

2018-05-22, Article, 10.1128/mBio.02392-17more

Abstract:
Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus (T2DM). With a randomized clinical trial, we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically designed herbal formula (AMC). Four hundred fifty patients with T2DM and hyperlipidemia were randomly assigned to either the metformin- or AMC-treated group. After 12 weeks of treatment, 100 patients were randomly selected from each group and assessed for clinical improvement. The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods. Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients. They significantly increased a coabundant group represented by spp., which significantly correlated with the improvements in glucose and lipid homeostasis. However, AMC showed better efficacies in improving homeostasis model assessment of insulin resistance (HOMA-IR) and plasma triglyceride and also exerted a larger effect on gut microbiota. Furthermore, only AMC increased the coabundant group represented by spp., which was previously reported to be associated with the alleviation of T2DM in a randomized clinical trial. Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria, such as and spp. Metabolic diseases such as T2DM and obesity have become a worldwide public health threat. Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases, and thus the gut microbiota serves as a promising target for disease control. In this study, we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs: metformin and a specifically designed Chinese herbal formula (AMC) for diabetic patients with hyperlipidemia. Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota. spp. were identified as being associated with improvements in glucose and lipid homeostasis for both drugs. AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels, which were associated with the enrichment of spp. In brief, these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula.

First Authors:
Xiaolin Tong,Jia Xu,Fengmei Lian

Correspondence Authors:
Xiaolin Tong,Liping Zhao

All Authors:
Xiaolin Tong,Jia Xu,Fengmei Lian,Xiaotong Yu,Yufeng Zhao,Lipeng Xu,Menghui Zhang,Xiyan Zhao,Jian Shen,Shengping Wu,Xiaoyan Pang,Jiaxing Tian,Chenhong Zhang,Qiang Zhou,Linhua Wang,Bing Pang,Feng Chen,Zhiping Peng,Jing Wang,Zhong Zhen,Chao Fang,Min Li,Limei Chen,Liping Zhao