[The intestinal microbiome and metabolic diseases : From obesity to diabetes and nonalcoholic steatohepatitis].

BACKGROUND

The intestinal microbiome consists of about 10 million genes, many of which encode digestive enzymes. This explains why animal and human experiments revealed that the intestinal microbiome adapts to food intake and optimizes energy harvest from food. This function is considered beneficial in states of lack of food, but following overnutrition, it might support the development of obesity.

OBJECTIVES

The relevance of the intestinal microbiome for the pathogenesis of obesity and associated metabolic diseases such as fatty liver disease and type 2 diabetes mellitus and for the clinical management of such diseases shall be discussed.

MATERIALS AND

METHODS

Recent literature related to the topic has been selected, presented, and discussed with regard to the objectives.

RESULTS

The intestinal microbiome plays a role in the pathogenesis of both obesity (by increasing the energy absorption from food) and fatty liver disease as well as type 2 diabetes mellitus (via induction of low-grade inflammation following translocation of lipopolysaccharides from the gut and dysregulation of metabolic pathways).

CONCLUSIONS

The findings might have consequences for diagnosis (identification of risk groups) and therapy (usage of known and novel probiotics or bacterial metabolites) of metabolic diseases.