肠道菌群紊乱与糖尿病心肌病

doi:10.16352/j.issn.1001-6325.2026.01.0129

基础医学与临床 ›› 2026, Vol. 46 ›› Issue (1): 129-133.doi: 10.16352/j.issn.1001-6325.2026.01.0129

肠道菌群紊乱与糖尿病心肌病

孙清怡¹, 陈果¹, 符晓¹, 孙海建¹, 陆清波^2*

1.江南大学无锡医学院临床医学系,江苏无锡 214122;
2.江南大学附属医院内分泌科,江苏无锡 214122

收稿日期:2025-02-18 修回日期:2025-05-06 出版日期:2026-01-05 发布日期:2025-12-29
通讯作者: ^*bonnielqb@yeah.net
基金资助:
国家自然科学基金(82370364,82170424)

Gut microbiota dysbiosis and diabetic cardiomyopathy

SUN Qingyi¹, CHEN Guo¹, FU Xiao¹, SUN Haijian¹, LU Qingbo^2*

1. Department of Clinical Medicine, Wuxi Medical College of Jiangnan University, Wuxi 214122;
2. Department of Endocrinology, Affiliated Hospital of Jiangnan University, Wuxi 214122, China

Received:2025-02-18 Revised:2025-05-06 Online:2026-01-05 Published:2025-12-29
Contact: ^*bonnielqb@yeah.net

摘要/Abstract

摘要： 肠道菌群及其代谢物紊乱主要通过氧化应激、能量代谢、炎性反应、胰岛素抵抗、细胞凋亡与自噬等导致糖尿病心肌病(DCM)。肠道菌群失衡通过肠道屏障功能损伤引发炎性反应和氧化应激,加剧心肌炎性反应和损伤。肠道菌群也可调节胆汁酸代谢,影响G蛋白偶联的胆汁酸受体(TGR5)的激活状态,进而影响糖脂代谢和心脏功能。肠道菌群代谢产物[如氧化三甲胺(TMAO)]可通过激活炎性反应通路,抑制胰岛素信号通路,降低胰岛素敏感性,导致糖代谢异常,加重DCM。调控肠道菌群组成及其代谢产物稳态可能为DCM的防治提供新策略。

关键词: 糖尿病, 心肌病变, 肠道菌群, 代谢紊乱, 胆汁酸

Abstract: Dysregulation of gut microbiota and its metabolites contributes to diabetic cardiomyopathy (DCM) primarily through inflammation, oxidative stress, energy metabolism disturbances, insulin resistance, apoptosis and autophagy. Gut microbiota dysbiosis disrupts intestinal barrier function, triggering inflammation and oxidative stress, which exacerbate myocardial inflammation and damage. Additionally, gut microbiota modulates bile acid metabolism, influencing the activation of Takeda G protein-coupled receptor 5(TGR5), thereby affecting glucose and lipid metabolism as well as cardiac function. Metabolites such as trimethylamine N-oxide (TMAO) may activate inflammatory pathways and impair insulin signaling, reducing insulin sensitivity and exacerbating glucose metabolism disorders, further aggravating DCM. Targeting the gut microbiota composition and restoring the homeostasis of its metabolites may be potential strategy for the prevention and treatment of DCM.

Key words: diabetes, cardiomyopathy, gut microbiota, metabolic disorder, bile acids

中图分类号:

R587.2

孙清怡, 陈果, 符晓, 孙海建, 陆清波. 肠道菌群紊乱与糖尿病心肌病[J]. 基础医学与临床, 2026, 46(1): 129-133.

SUN Qingyi, CHEN Guo, FU Xiao, SUN Haijian, LU Qingbo. Gut microbiota dysbiosis and diabetic cardiomyopathy[J]. Basic & Clinical Medicine, 2026, 46(1): 129-133.

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肠道菌群紊乱与糖尿病心肌病

Gut microbiota dysbiosis and diabetic cardiomyopathy

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