Bağırsak Mikrobiyotasının Obezite, İnsülin Direnci ve Diyabetteki Rolü
Diyabetes mellitus ve obezite çok sık görülen bir sağlık sorunudur. Bu metabolik hastalıklar tüm dünyada küresel bir sağlık sorunu haline gelmiş ve pek çok ülkede çocukluk ve adölesan çağdan başlayarak tüm yaş dönemlerinde hızla artmaya başlamıştır. Bugüne kadar kalori kısıtlaması ve medikal tedavi ile istenilen başarıya ulaşılamamıştır. Son çalışmalar obezitenin ve diyabetin gelişimi ile ilgili biyokimyasal yolları anlamaya yönelik yeni hedefl er sağlamıştır. Yakın geçmişte biriken kanıtlar da bağırsak mikrobiyotasının obezite, insülin direnci, tip 1 diyabet (T1D) ve tip 2 diyabet (T2D) gibi metabolik bozuklukların patogenezinde potansiyel yeni bir katkıda rol oynadığını ortaya koymuştur. Bağırsak mikrobiyotasına ait kısa zincirli yağ asitleri (KZYA), safra asiti ve biyoaktif lipidler gibi spesifi k metabolitler, enteroendokrin L hücrelerinde eksprese olan reseptörlerini aktive ederek inkretin hormon sekresyonunun düzenlenmesine katkıda bulunur. Bu inkretin hormon peptidleri gastrointestinal sistem, beyin, yağ dokusu ve karaciğer gibi geniş bir organ ve doku yelpazesini etkilemektedir. Bağırsak mikrobiyotasının metabolik hastalıkların patofizyolojisindeki rolünün anlaşılması ile prebiyotikler, probiyotikler ve fekal transplantasyon gibi yeni tedavi seçenekleri gündeme gelmiştir. Bağırsak mikrobiyota modifi kasyonu, obezitenin ve diyabetin önlenmesi veya sürecin tersine çevrilmesi için potansiyel bir terapötik strateji olabilir.
The Role of Intestinal Microbiota in Obesity, Inculin resistance and Diabetes
Diabetes mellitus and obesity are very common health problems. These metabolic diseases have become a global health problem all over the world and have begun to increase rapidly in all ages, starting with childhood and adolescence in many countries. Until today, the desired success has not been achieved with calorie restriction and medical treatment. Recent studies have provided new targets for understanding the biochemical pathways involved in the development of obesity and diabetes. Recent evidence has also shown that intestinal microbiota plays a potential new role in the pathogenesis of metabolic disorders such as obesity, insulin resistance, type 1 diabetes (T1D) and type 2 diabetes (T2D). Specifi c metabolites such as short chain fatty acids (SCFA), bile acid and bioactive lipids of the intestinal microbiota contribute to the regulation of incretin hormone secretion by activating receptors that are expressed on enteroendocrine L cells. These incretin hormone peptides affect a wide spectrum of organs and tissues such as the gastrointestinal tract, brain, fat tissue and liver. Understanding the role of intestinal microbiota in the pathophysiology of metabolic diseases has led to new therapeutic options such as prebiotics, probiotics and fecal transplantation. Intestinal microbiata modifi cation may be a potential therapeutic strategy for the prevention of obesity and diabetes or the reversal of the process.
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