medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-26-19-23medalphabet-3961Research ArticleПРАКТИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯPRACTICAL GASTROENTEROLOGYМетформин и микробиота кишечникаMetformin and intestinal microbiotahttps://orcid.org/0000-0003-0069-7744ГригорьеваИ. Н.Grigor'evaI. N.

Григорьева Ирина Николаевна - д.м.н., проф., главный научный сотрудник, руководитель группы биохимических исследований в гастроэнтерологии, проф. отдела образования

Scopus Author ID: 7004630757

Web of Science Researcher ID JGE‑0324-2023 

Новосибирск

Grigor'eva Irina N. - DM Sci (habil.), professor, chief researcher, head of the Group of Biochemical Research in Gastroenterology, professor of Education Dept

Scopus Author ID: 7004630757.

Web of Science Researcher ID JGE‑0324-2023

Novosibirsk

grigorieva2024@yandex.ruhttps://orcid.org/0000-0001-8514-2304РомановаТ. И.RomanovaT. I.

Романова Татьяна Ивановна - к.м.н., старший научный сотрудник лаборатории гастроэнтерологии

Новосибирск

Romanova Tatyana I. - PhD Med, senior researcher at Gastroenterology Laboratory

Novosibirsk

tarom75@mail.ruhttps://orcid.org/0000-0001-5809-2241СувороваТ. С.SuvorovaT. S.

Суворова Татьяна Станиславовна - к.м.н., доцент кафедры внутренних болезней

Новосибирск

Suvorova Tatyana S. - PhD Med, associate professor at Dept of Internal Medicine

Novosibirsk

tatyana.suvorova13@yandex.ruНепомнящихД. Л.NepomnyashchikhD. L.

Непомнящих Давид Львович - д.м.н., проф. кафедры внутренних болезней

Новосибирск

Nepomnyashchikh David L. - DM Sci (habil.), professor at Dept of Internal Medicine

Novosibirsk

dln_nco@mail.ruНаучно-исследовательский институт терапии и профилактической медицины – филиал ФГБНУ «Федеральный исследовательский центр институт цитологии и генетики Сибирского отделения Российской академии наук»РоссияResearch Institute of Therapy and Preventive Medicine – branch of the Federal Scientific Center “Institute of Cytology and Genetics” of the Siberian Branch of the RASRussian FederationФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава РоссииРоссияNovosibirsk State Medical UniversityRussian Federation202409112024026«Практическая гастроэнтерология» (2)1923Copyright © Григорьева И.Н., Романова Т.И., Суворова Т.С., Непомнящих Д.Л., 20242024Григорьева И.Н., Романова Т.И., Суворова Т.С., Непомнящих Д.Л.Grigor'eva I.N., Romanova T.I., Suvorova T.S., Nepomnyashchikh D.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3961

Целый ряд исследований на людях и животных продемонстрировали, что действие метформина по снижению гипергликемии может быть результатом модуляции популяции кишечной микробиоты. Метформин изменяет соотношение Firmicutes/Bacteroidetes, усиливает рост некоторых бактерий, таких как Akkermansia muciniphila, Escherichia spp. или Lactobacillus, и снижает уровни других, таких как Intestinibacter. Более того, в кишечнике метформин не только улучшает усвоение глюкозы, но также способствует выработке короткоцепочечных жирных кислот (КЦЖК), регулирует секрецию глюкозоснижающего гормона глюкагоноподобного пептида 1 (GLP‑1) и других кишечных пептидов, ингибирует фарнезоид-Х-рецептор (FXR) и резорбцию пула желчных кислот, может снижать проницаемость кишечного барьера за счет увеличения экспрессии муцина и белков плотных соединений, модулирует иммунный ответ, оказывает противовоспалительное действие и др. Таким образом, результаты исследований свидетельствуют о том, что кишечная микробиота участвует не только в сахароснижающем действии метформина при сахарном диабете 2 типа, но и в реализации его многочисленных плейотропных эффектов.

A number of human and animal studies have demonstrated that the hyperglycemia-lowering effects of metformin may result from modulation of the gut microbiota population. Metformin changes the Firmicutes/Bacteroidetes ratio and enhances the growth of some bacteria, such as Akkermansia muciniphila, Escherichia spp. or Lactobacillus and reduce the levels of others such as Intestinibacter. Moreover, in the intestine, metformin not only improves glucose absorption, but also promotes the production of short-chain fatty acids (SCFAs), regulates the secretion of the glucose-lowering hormone glucagon-like peptide 1 (GLP‑1) and other intestinal peptides, inhibits the Farnesoid-X-receptor (FXR) and resorption of the bile acid pool, and may reduce intestinal permeability barrier by increasing the expression of mucin and tight junction proteins, modulates the immune response, has an anti-inflammatory effect, etc. Thus, research results indicate that the intestinal microbiota is involved not only in the hypoglycemic effect of metformin in diabetes mellitus type 2, but also in the implementation of its numerous pleiotropic effects.

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The authors declare that there are no conflicts of interest present.