endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg10112endoserg-10112Research ArticleОбзоры литературыReview of literatureМикробиота кишечника у пациентов с ожирением и после бариатрических операцийGut microbiota in obese patients and after bariatric surgeryhttps://orcid.org/0000-0001-8817-1901ЕгшатянЛилит ВаниковнаEgshatyanLilit V.

к.м.н.

MD, PhD

lilit.egshatyan@yandex.ruhttps://orcid.org/0000-0003-1598-624XКушханашховаДана АслановнаKushkhanashkhovaDana A.

ординатор

resident physician

dana.kuch@mail.ruhttps://orcid.org/0000-0003-2735-9008ЕрмиловаЕкатерина СергеевнаErmilovaEkaterina S.

ординатор

resident physician

kate93@bk.ruhttps://orcid.org/0000-0002-6266-5855АскерхановРашид ГамидовичAskerkhanovRashid G.

Кандидат медицинских наук, заведующий центром бариатрической хирургии

MD, PhD

Askerkhanov@gmail.com<p>Московский клинический научный центр им. А.С. Логинова ДЗМ; Московский государственный медико-стоматологический университет им. А.И. Евдокимова</p>Россия<p>A.S. Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation; А.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation</p>Russian Federation<p>Московский государственный медико-стоматологический университет им. А.И. Евдокимова</p>Россия<p>А.I. Evdokimov Moscow State University of Medicine and Dentistry</p>Russian Federation<p>Московский клинический научный центр им. А.С. Логинова ДЗМ; Московский государственный медико-стоматологический университет им. А.И. Евдокимова</p>Россия<p>A.S. Loginov Moscow Clinical Scientific Center; А.I. Evdokimov Moscow State University of Medicine and Dentistry</p>Russian Federation201907082019131516Copyright &#x00A9; Егшатян Л.В., Кушханашхова Д.А., Ермилова Е.С., Аскерханов Р.Г., 20192019Егшатян Л.В., Кушханашхова Д.А., Ермилова Е.С., Аскерханов Р.Г.Egshatyan L.V., Kushkhanashkhova D.A., Ermilova E.S., Askerkhanov R.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/10112

В статье представлен обзор современной литературы, обобщающий экспериментальные и клинические данные о связи ожирения с изменениями состава микробиоты кишечника, а также о влиянии бариатрических операций на массу тела и качественный состав микробиоты. Доказано, что микробиота кишечника является своеобразным индикатором состояния макроорганизма, реагируя на возрастные, физиологические, диетические, климато-географические факторы изменением своего качественного и количественного состава. Эти изменения приводят к повышению ее метаболической активности с образованием дополнительной энергии от съеденной пищи, способствуя усвоению питательных веществ и удлинению времени хранения в жировой ткани через разнообразные механизмы. Обнаружено, что микробиота кишечника влияет на энергобаланс не только за счет эффективного извлечения энергии из питательных веществ, но и за счет воздействия на гены, регулирующие ее расход и запасание. При всей сложности вопроса о причинно-следственной связи изменений состава микробиоты и ожирения, совокупность полученных данных обосновывает положение, что качественные и количественные изменения микробиоты кишечника могут способствовать развитию ожирения. Обнаружено, что индуцированные бариатрическими операциями метаболические и микробные модификации могут способствовать снижению веса, улучшению метаболических процессов и, как следствие, увеличению здорового периода и продолжительности жизни. Результаты этих исследований открывают новые возможности в лечении ожирения и поддержании веса с помощью модификации микробиоты и использования “здоровых” микробных сообществ в качестве “лекарственного средства”.

In this review are discussed experimental and clinical data about the role of gut microbiota and its changes after bariatric surgery. To date, bariatric surgery represents the only treatment that enables substantial and sustained weight loss.

The large intestinal microbiota plays an important role in normal bowel function and the maintenance of host health through the formation of short chain fatty acids, modulation of immune system reactivity, and development of colonization resistance. The intestinal microflora is a peculiar indicator of the condition of a microorganism reacting to age, physiological, dietary, and geographical factors from change of qualitative and quantitative structure. Studies have demonstrated that obesity and metabolic syndrome may be associated with profound microbiotal changes. This Review outlines the potential mechanisms by which the major changes in the digestive tract after bariatric surgery can affect the gut microbiota.

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The authors declare that there are no conflicts of interest present.