全球范围内肥胖和2型糖尿病（T2DM）的患病率正在以惊人的速度上升。肠道微生物在这些代谢紊乱疾病中的潜在作用目前已经明确。研究表明，肥胖与肠道菌群的组成变化有关，肥胖者的微生物组成可能更高效率地从饮食中获取能量。瘦的男性志愿者粪便移植（FMT）于罹患代谢综合征的男性后可显著提高代谢综合征患者肠道微生物多样性和胰岛素敏感性，其中丁酸产生菌明显增加。这些肠道菌群组成差异或可作为高危患者2型糖尿病病程发展的早期诊断标志物。肠道微生物如丁酸产生菌可能通过基因表达和激素调节的不同途径改善线粒体活性代谢，预防代谢性内毒素血症和激活肠道糖异生。未来的研究应集中在细菌产物（如丁酸）是否具有与肠道细菌具有相同的效果，最终对肥胖和糖尿病进行更成功干预。目前相关的技术正在迅速发展，包括使用粪便移植，已显示出可喜的成果，是未来的微生物新疗法的希望。该文章发表于Diabetes Care January 2015 vol. 38 no. 1159-165.

    摘要原文：

    Insights Into the Role of the Microbiome in Obesity and Type 2 DiabetesThe worldwide prevalence of obesity and type 2 diabetes mellitus （T2DM） continues to rise at an alarming pace. Recently the potential role of the gut microbiome in these metabolic disorders has been identified. Obesity is associated with changes in the composition of the intestinal microbiota, and the obese microbiome seems to be more efficient in harvesting energy from the diet. Lean male donor fecal microbiota transplantation （FMT） in males with metabolic syndrome resulted in a significant improvement in insulin sensitivity in conjunction with an increased intestinal microbial diversity, including a distinct increase in butyrate-producing bacterial strains. Such differences in gut microbiota composition might function as early diagnostic markers for the development of T2DM in high-risk patients. Products of intestinal microbes such as butyrate may induce beneficial metabolic effects through enhancement of mitochondrial activity, prevention of metabolic endotoxemia, and activation of intestinal gluconeogenesis via different routes of gene expression and hormone regulation. Future research should focus on whether bacterial products （like butyrate） have the same effects as the intestinal bacteria that produce it, in order to ultimately pave the way for more successful interventions for obesity and T2DM. The rapid development of the currently available techniques, including use of fecal transplantations, has already shown promising results, so there is hope for novel therapies based on the microbiota in the future.