Obezite ile Barsak Mikrobiyotası İlişkisi ve Obezitede Prebiyotikler ve Probiyotiklerin Kullanımı

Obezite, enerji alımı ve harcanması arasındaki dengesizlikten dolayı vücutta aşırı yağ birikmesidir. Obeziteye neden olan en önemli etyolojik etmenler genetik (kişisel yatkınlık) ve çevresel etmenlerdir (yaşam tarzı). Bu hipotez yaygın olarak kabul edilmekle birlikte, obezitenin son 30 yıldaki artışı sadece genetik etmenlerle açıklanamamaktadır. Son yıllarda, obezite ve komplikasyonlarının gelişiminde barsak mikrobiyotasının da rol oynayabileceği anlaşılmıştır. Barsak flora bakterileri, vücudun yağlanmasında farklı mekanizmalarla (diyetteki liflerden enerji elde edilmesi, barsak permeabilitesinin regulasyonu, düşük düzeyde enflamasyonun artması, dokuların yağ asidi bileşiminin düzenlenmesi ve barsak kaynaklı peptit salgılanması gibi) etki göstermektedir. Obez insanların barsaklarında Bacteroidetes azalmakta ve Firmicutes artmakta, ayrıca barsaklarda bakteriyel çeşitlilikte de azalma olmaktadır. Ağırlık kaybı ile bu değişim geri dönmektedir. Bazı yeni çalışmalarda prebiyotik ve probiyotik kullanımının barsak florasını dengelediği ve ağırlık kaybına yardım ettiği de belirlenmiştir. Sonuç olarak, prebiyotikler, probiyotikler ve bunların kombinasyonları gibi bazı tedavilerin barsak mikrobiyotası üzerine olan etkilerinin ve böylece obezitenin tedavisi ve önlenmesinde kullanımının incelendiği büyük ve uzun süreli çalışmalara gereksinme vardır.

Relationship Between Obesity and Intestinal Microbiota and Pre-and Probiotics Usage in Obesity

Obesity results from the accumulation of excess fat tissue caused by imbalance between energy intake and expenditure. Genetic (host susceptibility) and environmental (lifestyle) factors are main etiologic causes of obesity. Although this hypothesis is widely accepted, the growing incidence of obesity over the last 30 years cannot solely be explained by genetic factors. Recent evidence suggests that enteric microbiota may play a significant role in the development of obesity and related complications. The intestinal microbiota may stimulate fat deposition in the body through several mechanisms: e.g., energy harvest from the dietary fibers, regulation of gut permeability, increasing low-grade inflammation, modulation of tissue fatty acid composition, and gut-derived peptide secretion. Human obesity is associated with a low abundance of intestinal Bacteroidetes and high abundance of Firmicutes, and with reduced bacterial diversity. Moreover, these changes can be reversed by weight loss. Some new studies showed that prebiotics and probiotics can modulate intestinal microbiota and help weight loss. In conclusion, long-term large-sscale studies should be done using targeted interventions, including prebiotics, probiotics and combinations to manipulate gut microbiota in order to treat and prevent obesity.

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