Frontiers in endocrinology · 2026
Metabolic regulatory mechanisms of Yijinjing exercise in patients with type 2 diabetes mellitus: Insight from the gut microbiota-intestinal barrier- inflammation axis.
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Li Min, Yang Xinhai, Wen Yali
Аннотация
OBJECTIVE: This study aimed to explore the impact of Yijinjing exercise on glucose metabolic homeostasis, systemic inflammatory markers, and the composition of gut microbiota in individuals diagnosed with type 2 diabetes mellitus (T2DM).
METHODS: A total of 45 T2DM patients participated in a 6-month structured Yijinjing exercise program. Body composition metrics were evaluated via bioelectrical impedance analysis. Standard biochemical indices, such as fasting insulin, blood glucose, lipid profiles (total cholesterol, triglycerides, and high/low-density lipoprotein cholesterol), and glycated hemoglobin (HbA1c), were quantified using automated laboratory analyzers. Serum concentrations of inflammatory cytokines (TNF-α, IL-6, IL-1β, IL-10, CRP), intestinal barrier permeability markers (D-lactate and Zonulin), and the mucosal repair factor MFG-E8 were determined through enzyme-linked immunosorbent assay (ELISA). Furthermore, the gut microbial community structure was profiled by 16S rRNA gene sequencing.
RESULTS: Following the 6-month intervention, participants demonstrated a significant improvement in body composition, characterized by reductions in body weight, BMI, waist circumference, and body fat percentage, coupled with an increase in lean mass (P < 0.05). Metabolic and inflammatory profiles showed notable improvements, with decreased levels of fasting blood glucose, HbA1c, HOMA-IR, CRP, TNF-α, IL-6, IL-1β, IL-8, and total cholesterol, while the anti-inflammatory cytokine IL-10 was significantly upregulated (P < 0.01). Ecological analysis of the gut microbiota indicated an increase in both Chao1 and Shannon diversity indices (P < 0.05). Specifically, the abundance of beneficial taxa, such as Lactobacillus and Bifidobacterium, was markedly elevated; conversely, potential pathogens including Escherichia coli, Klebsiella pneumoniae, Desulfovibrio, and Candida albicans were significantly suppressed (P < 0.01). Furthermore, the intervention mitigated intestinal mucosal damage, as evidenced by the downregulation of D-LA and Zonulin and the upregulation of MFG-E8 (P < 0.01).
CONCLUSION: T2DM is associated with gut dysbiosis, compromised intestinal barrier integrity, and chronic systemic inflammation. Yijinjing exercise serves as an effective intervention to optimize glucose control, restore microbial diversity, fortify the intestinal mucosal barrier, and suppress systemic inflammation. These improvements occurred concurrently with significant remodeling of the gut microbiota, intestinal barrier restoration, and resolution of systemic inflammation, suggesting that gut microbiota modulation may have contributed, at least in part, to the observed metabolic benefits. These results suggest that Yijinjing exercise, as a non-pharmacological approach associated with favorable gut microbiota adaptations, may represent a valuable and personalized strategy for T2DM management, though further studies are warranted to establish the directionality and independence of these interrelated pathways.
METHODS: A total of 45 T2DM patients participated in a 6-month structured Yijinjing exercise program. Body composition metrics were evaluated via bioelectrical impedance analysis. Standard biochemical indices, such as fasting insulin, blood glucose, lipid profiles (total cholesterol, triglycerides, and high/low-density lipoprotein cholesterol), and glycated hemoglobin (HbA1c), were quantified using automated laboratory analyzers. Serum concentrations of inflammatory cytokines (TNF-α, IL-6, IL-1β, IL-10, CRP), intestinal barrier permeability markers (D-lactate and Zonulin), and the mucosal repair factor MFG-E8 were determined through enzyme-linked immunosorbent assay (ELISA). Furthermore, the gut microbial community structure was profiled by 16S rRNA gene sequencing.
RESULTS: Following the 6-month intervention, participants demonstrated a significant improvement in body composition, characterized by reductions in body weight, BMI, waist circumference, and body fat percentage, coupled with an increase in lean mass (P < 0.05). Metabolic and inflammatory profiles showed notable improvements, with decreased levels of fasting blood glucose, HbA1c, HOMA-IR, CRP, TNF-α, IL-6, IL-1β, IL-8, and total cholesterol, while the anti-inflammatory cytokine IL-10 was significantly upregulated (P < 0.01). Ecological analysis of the gut microbiota indicated an increase in both Chao1 and Shannon diversity indices (P < 0.05). Specifically, the abundance of beneficial taxa, such as Lactobacillus and Bifidobacterium, was markedly elevated; conversely, potential pathogens including Escherichia coli, Klebsiella pneumoniae, Desulfovibrio, and Candida albicans were significantly suppressed (P < 0.01). Furthermore, the intervention mitigated intestinal mucosal damage, as evidenced by the downregulation of D-LA and Zonulin and the upregulation of MFG-E8 (P < 0.01).
CONCLUSION: T2DM is associated with gut dysbiosis, compromised intestinal barrier integrity, and chronic systemic inflammation. Yijinjing exercise serves as an effective intervention to optimize glucose control, restore microbial diversity, fortify the intestinal mucosal barrier, and suppress systemic inflammation. These improvements occurred concurrently with significant remodeling of the gut microbiota, intestinal barrier restoration, and resolution of systemic inflammation, suggesting that gut microbiota modulation may have contributed, at least in part, to the observed metabolic benefits. These results suggest that Yijinjing exercise, as a non-pharmacological approach associated with favorable gut microbiota adaptations, may represent a valuable and personalized strategy for T2DM management, though further studies are warranted to establish the directionality and independence of these interrelated pathways.