Obesidade e Microbiota Intestinal: o que sabemos até agora?
Obesity and Gut Microbiota: what do we know so far?
DOI:
https://doi.org/10.34119/bjhrv5n5-272Keywords:
obesidade, microbiota intestinal, revisãoAbstract
Introdução: A obesidade é um problema de importância global, que vem aumentando significativamente ao longo das últimas décadas. Estima-se que há mais de 600 milhões de adultos obesos. Diversos tratamentos já estão estabelecidos na literatura, tais quais dietas/mudança de estilo de vida, medicações como Liraglutida e cirurgia bariátrica. O papel da microbiota intestinal na obesidade é desempenhado por diversos mecanismos, como aumento do funcionamento de células enteroendócrinas, homeostase de glicose e leptina e manutenção de GLP-2. Há impacto da microbiota na redução do peso, IMC, circunferência abdominal e gordura corpórea. O objetivo deste trabalho foi encontrar os dados conhecidos até o momento sobre o papel da microbiota intestinal na obesidade e quais lacunas havia nessa relação. Método: busca na literatura por artigos sobre microbiota intestinal e obesidade, pelo método PRISMA.Resultado: estudos mostraram associação entre espécies presentes na microbiota e obesidade em diversas populações. Foi observado que a suplementação de prebióticos associada à dieta teve maior impacto no peso e gordura corpórea do que apenas a dieta. Os probióticos também impactaram na DM (1 e 2), síndrome metabólica e gravidez. Discussão: Faltam estudos mais sistematizados sobre espécies e quantidades para permitir aplicação prática da suplementação de probióticos. Conclusão: Apesar de mais estudos serem necessários para elucidar a prática da suplementação, a influência da microbiota intestinal na obesidade já é clara.
References
Apovian CM. Obesity: definition, comorbidities, causes, and burden. The American Journal of Managed Care [Internet]. 2016 Jun 1;22(7 Suppl):s176-185. Available from: https://pubmed.ncbi.nlm.nih.gov/27356115/
The GBD 2015 Obesity Collaborators. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. New England Journal of Medicine [Internet]. 2017 Jul 6;377(1):13–27. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa1614362
Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. Obesity and Lipotoxicity [Internet]. 2017;960:1–17. Available from: https://link.springer.com/chapter/10.1007/978-3-319-48382-5_1
Gomes DCK, Sichieri R, Junior EV, Boccolini CS, de Moura Souza A, Cunha DB. Trends in obesity prevalence among Brazilian adults from 2002 to 2013 by educational level. BMC Public Health. 2019 Jul 18;19(1).
Blüher M. Obesity: global epidemiology and pathogenesis. Nature Reviews Endocrinology [Internet]. 2019 Feb 27;15(5):288–98. Available from: https://www.nature.com/articles/s41574-019-0176-8
Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, et al. European Guidelines for Obesity Management in Adults. Obesity Facts. 2015;8(6):402–24.
Pigeyre M, Yazdi Fereshteh T, Kaur Y, Meyre D. Recent progress in genetics, epigenetics and metagenomics unveils the pathophysiology of human obesity. Clinical Science. 2016 May 6;130(12):943–86.
Mitchell NS, Catenacci VA, Wyatt HR, Hill JO. Obesity: Overview of an Epidemic. Psychiatric Clinics of North America [Internet]. 2011 Dec;34(4):717–32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228640/
Sokol H. [Definition and roles of the gut microbiota]. La Revue Du Praticien [Internet]. 2019 Sep 1;69(7):776–82. Available from: https://pubmed.ncbi.nlm.nih.gov/32233323/
Thursby E, Juge N. Introduction to the human gut microbiota. Biochemical Journal. 2017 May 16;474(11):1823–36.
Lin L, Zhang J. Role of intestinal microbiota and metabolites on gut homeostasis and human diseases. BMC Immunology [Internet]. 2017 Jan 6;18(1). Available from: https://bmcimmunol.biomedcentral.com/articles/10.1186/s12865-016-0187-3
Stecher B. The Roles of Inflammation, Nutrient Availability and the Commensal Microbiota in Enteric Pathogen Infection. Conway T, Cohen P, editors. Microbiology Spectrum. 2015 Jun 18;3(3).
Han H, Li Y, Fang J, Liu G, Yin J, Li T, et al. Gut Microbiota and Type 1 Diabetes. International Journal of Molecular Sciences [Internet]. 2018 Mar 27;19(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979537/
Tang WHW, Kitai T, Hazen SL. Gut Microbiota in Cardiovascular Health and Disease. Circulation research [Internet]. 2017;120(7):1183–96. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28360349
Forslund K, Hildebrand F, Nielsen T, Falony G, Le Chatelier E, Sunagawa S, et al. Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota. Nature. 2015 Dec;528(7581):262–6.
Cerdó T, García-Santos J, G. Bermúdez M, Campoy C. The Role of Probiotics and Prebiotics in the Prevention and Treatment of Obesity. Nutrients [Internet]. 2019 Mar 15;11(3):635. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470608/
Abenavoli L, Scarpellini E, Colica C, Boccuto L, Salehi B, Sharifi-Rad J, et al. Gut Microbiota and Obesity: A Role for Probiotics. Nutrients [Internet]. 2019 Nov 7;11(11). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893459/
Sáez-Lara MJ, Robles-Sanchez C, Ruiz-Ojeda FJ, Plaza-Diaz J, Gil A. Effects of Probiotics and Synbiotics on Obesity, Insulin Resistance Syndrome, Type 2 Diabetes and Non-Alcoholic Fatty Liver Disease: A Review of Human Clinical Trials. International Journal of Molecular Sciences [Internet]. 2016 Jun 13;17(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926461/
Cuevas-Sierra A, Ramos-Lopez O, Riezu-Boj JI, Milagro FI, Martinez JA. Diet, Gut Microbiota, and Obesity: Links with Host Genetics and Epigenetics and Potential Applications. Advances in Nutrition [Internet]. 2019 Jan 1 [cited 2020 Dec 9];10(suppl_1):S17–30. Available from: https://academic.oup.com/advances/article/10/suppl_1/S17/5307226
Shen J, Obin MS, Zhao L. The gut microbiota, obesity and insulin resistance. Molecular Aspects of Medicine. 2013 Feb;34(1):39–58.
Torres-Fuentes C, Schellekens H, Dinan TG, Cryan JF. The microbiota–gut–brain axis in obesity. The Lancet Gastroenterology & Hepatology. 2017 Oct;2(10):747–56.
Martinez KB, Pierre JF, Chang EB. The Gut Microbiota. Gastroenterology Clinics of North America. 2016 Dec;45(4):601–14.
Indiani CM dos SP, Rizzardi KF, Castelo PM, Ferraz LFC, Darrieux M, Parisotto TM. Childhood Obesity and Firmicutes/Bacteroidetes Ratio in the Gut Microbiota: A Systematic Review. Childhood Obesity. 2018 Dec;14(8):501–9.
Seganfredo FB, Blume CA, Moehlecke M, Giongo A, Casagrande DS, Spolidoro JVN, et al. Weight-loss interventions and gut microbiota changes in overweight and obese patients: a systematic review. Obesity Reviews. 2017 May 19;18(8):832–51.
Castaner O, Goday A, Park Y-M, Lee S-H, Magkos F, Shiow S-ATE, et al. The Gut Microbiome Profile in Obesity: A Systematic Review. International Journal of Endocrinology. 2018;2018:1–9.
Crovesy L, Masterson D, Rosado EL. Profile of the gut microbiota of adults with obesity: a systematic review. European Journal of Clinical Nutrition. 2020 Mar 30;74(9):1251–62.
EJTAHED H-S, ANGOORANI P, SOROUSH A-R, HASANI-RANJBAR S, SIADAT S-D, LARIJANI B. Gut microbiota-derived metabolites in obesity: a systematic review. Bioscience of Microbiota, Food and Health. 2020;
Pisanu S, Palmas V, Madau V, Casula E, Deledda A, Cusano R, et al. Impact of a Moderately Hypocaloric Mediterranean Diet on the Gut Microbiota Composition of Italian Obese Patients. Nutrients. 2020 Sep 4;12(9):2707.
Cabral LQT, Ximenez JA, Moreno KGT, Fernandes R. Probiotics have minimal effects on appetite-related hormones in overweight or obese individuals: A systematic review of randomized controlled trials. Clinical Nutrition. 2021 Apr;40(4):1776–87.
López-Moreno A, Suárez A, Avanzi C, Monteoliva-Sánchez M, Aguilera M. Probiotic Strains and Intervention Total Doses for Modulating Obesity-Related Microbiota Dysbiosis: A Systematic Review and Meta-analysis. Nutrients. 2020 Jun 29;12(7):1921.
Park S, Bae J-H. Probiotics for weight loss: a systematic review and meta-analysis. Nutrition Research. 2015 Jul;35(7):566–75.
Álvarez-Arraño V, Martín-Peláez S. Effects of Probiotics and Synbiotics on Weight Loss in Subjects with Overweight or Obesity: A Systematic Review. Nutrients. 2021 Oct 17;13(10):3627.
XU Z, JIANG W, HUANG W, LIN Y, CHAN FKL, NG SC. Gut microbiota in patients with obesity and metabolic disorders — a systematic review. Genes & Nutrition. 2022 Jan 29;17(1).
Pinart M, Dötsch A, Schlicht K, Laudes M, Bouwman J, Forslund SK, et al. Gut Microbiome Composition in Obese and Non-Obese Persons: A Systematic Review and Meta-Analysis. Nutrients. 2021 Dec 21;14(1):12.
Koutoukidis DA, Jebb SA, Zimmerman M, Otunla A, Henry JA, Ferrey A, et al. The association of weight loss with changes in the gut microbiota diversity, composition, and intestinal permeability: a systematic review and meta-analysis. Gut Microbes. 2022 Jan 18;14(1).
Inchingolo AD, Malcangi G, Inchingolo AM, Piras F, Settanni V, Garofoli G, et al. Benefits and Implications of Resveratrol Supplementation on Microbiota Modulations: A Systematic Review of the Literature. International Journal of Molecular Sciences. 2022 Apr 5;23(7):4027.
Cao TTB, Wu K-C, Hsu J-L, Chang C-S, Chou C, Lin C-Y, et al. Effects of Non-insulin Anti-hyperglycemic Agents on Gut Microbiota: A Systematic Review on Human and Animal Studies. Frontiers in Endocrinology [Internet]. 2020 Sep 23 [cited 2022 Jul 6];11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538596/
Grabia M, Markiewicz-Żukowska R, Socha K. Prevalence of Metabolic Syndrome in Children and Adolescents with Type 1 Diabetes Mellitus and Possibilities of Prevention and Treatment: A Systematic Review. Nutrients. 2021 May 23;13(6):1782.
Dreisbach C, Prescott S, Alhusen J. Influence of Maternal Prepregnancy Obesity and Excessive Gestational Weight Gain on Maternal and Child Gastrointestinal Microbiome Composition: A Systematic Review. Biological Research for Nursing [Internet]. 2020 Jan 1 [cited 2022 Jul 6];22(1):114–25. Available from: https://pubmed.ncbi.nlm.nih.gov/31597472/
Wang C-C, Tung Y-T, Chang H-C, Lin C-H, Chen Y-C. Effect of Probiotic Supplementation on Newborn Birth Weight for Mother with Gestational Diabetes Mellitus or Overweight/Obesity: A Systematic Review and Meta-Analysis. Nutrients. 2020 Nov 12;12(11):3477.
Grech A, Collins CE, Holmes A, Lal R, Duncanson K, Taylor R, et al. Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis. Gut Microbes. 2021 Jan 1;13(1):1–30.
Guo Y, Huang Z-P, Liu C-Q, Qi L, Sheng Y, Zou D-J. Modulation of the gut microbiome: a systematic review of the effect of bariatric surgery. European Journal of Endocrinology [Internet]. 2018 Jan 1 [cited 2022 Jul 6];178(1):43–56. Available from: https://pubmed.ncbi.nlm.nih.gov/28916564/
Ejtahed H-S, Angoorani P, Hasani-Ranjbar S, Siadat S-D, Ghasemi N, Larijani B, et al. Adaptation of human gut microbiota to bariatric surgeries in morbidly obese patients: A systematic review. Microbial Pathogenesis. 2018 Mar;116:13–21.
Morales‐Marroquin E, Hanson B, Greathouse L, Cruz‐Munoz N, Messiah SE. Comparison of methodological approaches to human gut microbiota changes in response to metabolic and bariatric surgery: A systematic review. Obesity Reviews. 2020 Apr 6;21(8).
Davies Naomi K, O’Sullivan JM, Plank LD, Murphy R. Altered gut microbiome after bariatric surgery and its association with metabolic benefits: A systematic review. Surgery for Obesity and Related Diseases. 2019 Apr;15(4):656–65.
Penney NC, Kinross J, Newton RC, Purkayastha S. The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review. International Journal of Obesity. 2015 Jun 17;39(11):1565–74.
Luijten JCHBM, Vugts G, Nieuwenhuijzen GAP, Luyer MDP. The Importance of the Microbiome in Bariatric Surgery: a Systematic Review. Obesity Surgery [Internet]. 2019 Apr 13 [cited 2019 Dec 10];29(7):2338–49. Available from: https://link.springer.com/article/10.1007%2Fs11695-019-03863-y
Crovesy L, Ostrowski M, Ferreira DMTP, Rosado EL, Soares-Mota M. Effect of Lactobacillus on body weight and body fat in overweight subjects: a systematic review of randomized controlled clinical trials. International Journal of Obesity. 2017 Jul 10;41(11):1607–14.
Dror T, Dickstein Y, Dubourg G, Paul M. Microbiota manipulation for weight change. Microbial Pathogenesis. 2017 May;106:146–61.
da Silva Borges D, Fernandes R, Thives Mello A, da Silva Fontoura E, Soares dos Santos AR, Santos de Moraes Trindade EB. Prebiotics may reduce serum concentrations of C-reactive protein and ghrelin in overweight and obese adults: a systematic review and meta-analysis. Nutrition Reviews. 2019 Sep 5;
Roshanravan N, Bastani S, Tutunchi H, Kafil B, Nikpayam O, Mesri Alamdari N, et al. A comprehensive systematic review of the effectiveness of Akkermansia muciniphila, a member of the gut microbiome, for the management of obesity and associated metabolic disorders. Archives of Physiology and Biochemistry. 2021 Jan 15;1–11.
Pontes KS da S, Guedes MR, Cunha MR da, Mattos S de S, Barreto Silva MI, Neves MF, et al. Effects of probiotics on body adiposity and cardiovascular risk markers in individuals with overweight and obesity: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition. 2021 Aug;40(8):4915–31.
Tarantino G, Finelli C. Systematic review on intervention with prebiotics/probiotics in patients with obesity-related nonalcoholic fatty liver disease. Future Microbiology. 2015 May;10(5):889–902.
Mohammadi H, Ghavami A, Hadi A, Askari G, Symonds M, Miraghajani M. Effects of pro-/synbiotic supplementation on anthropometric and metabolic indices in overweight or obese children and adolescents: A systematic review and meta-analysis. Complementary Therapies in Medicine [Internet]. 2019 Jun [cited 2019 Dec 10];44:269–76. Available from: https://www.sciencedirect.com/science/article/pii/S0965229919303395
Lane M, Howland G, West M, Hockey M, Marx W, Loughman A, et al. The effect of ultra-processed very low-energy diets on gut microbiota and metabolic outcomes in individuals with obesity: A systematic literature review. Obesity Research & Clinical Practice. 2020 May;14(3):197–204.
Angoorani P, Ejtahed H-S, Hasani-Ranjbar S, Siadat SD, Soroush AR, Larijani B. Gut microbiota modulation as a possible mediating mechanism for fasting-induced alleviation of metabolic complications: a systematic review. Nutrition & Metabolism [Internet]. 2021 Dec 14;18:105. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670288/
Attaye I, van Oppenraaij S, Warmbrunn MV, Nieuwdorp M. The Role of the Gut Microbiota on the Beneficial Effects of Ketogenic Diets. Nutrients. 2021 Dec 31;14(1):191.
Green JE, Davis JA, Berk M, Hair C, Loughman A, Castle D, et al. Efficacy and safety of fecal microbiota transplantation for the treatment of diseases other than Clostridium difficile infection: a systematic review and meta-analysis. Gut Microbes. 2020 Nov 9;12(1):1854640.
Proença IM, Allegretti JR, Bernardo WM, de Moura DTH, Ponte Neto AM, Matsubayashi CO, et al. Fecal microbiota transplantation improves metabolic syndrome parameters: systematic review with meta-analysis based on randomized clinical trials. Nutrition Research. 2020 Nov;83:1–14.
Zhang Z, Mocanu V, Cai C, Dang J, Slater L, Deehan EC, et al. Impact of Fecal Microbiota Transplantation on Obesity and Metabolic Syndrome—A Systematic Review. Nutrients. 2019 Sep 25;11(10):2291.
Ilyas Z, Perna S, Al-thawadi S, Alalwan TA, Riva A, Petrangolini G, et al. The effect of Berberine on weight loss in order to prevent obesity: A systematic review. Biomedicine & Pharmacotherapy. 2020 Jul;127:110137.
Ejtahed H-S, Soroush A-R, Siadat S-D, Hoseini-Tavassol Z, Larijani B, Hasani-Ranjbar S. Targeting obesity management through gut microbiota modulation by herbal products: A systematic review. Complementary Therapies in Medicine. 2019 Feb;42:184–204.
Bond T, Derbyshire E. Tea Compounds and the Gut Microbiome: Findings from Trials and Mechanistic Studies. Nutrients. 2019 Oct 3;11(10):2364.
Kim KN, Yao Y, Ju SY. Short Chain Fatty Acids and Fecal Microbiota Abundance in Humans with Obesity: A Systematic Review and Meta-Analysis. Nutrients. 2019 Oct 18;11(10):2512.
Rasmussen SH, Shrestha S, Bjerregaard LG, Ängquist LH, Baker JL, Jess T, et al. Antibiotic exposure in early life and childhood overweight and obesity: A systematic review and meta-analysis. Diabetes, Obesity and Metabolism. 2018 Feb 25;20(6):1508–14.
